abdominal

Question 1

gaviscon

Answer 1

antacid

Question 2

how does gaviscon work

Answer 2

contain an alginate + antacids (sodium bicarb)

antacids buffer stomach acids
alignates increase viscocity of stomach contents = reduce reflux of stomach acid. react w gastric contents = floating raft = separate gastric content to prevent mucosal damage

Question 3

indications for gavison/antacids

Answer 3

GORD -symptomatic relife of heart burn

dyspepsia (indigestion) - short term relife

Question 4

contraindications for gaviscon/antacids

Answer 4

sodium and potassium containing prepatons as can cause fluid overload or hyperkalaemia

Question 5

ranitidine

Answer 5

H2 antagonist

Question 6

H2 antagonist mode of action

Answer 6

reduce gastric acid secretion

Question 7

indications for H2 antagonist

Answer 7

peptic ulcer disease

GORD and dyspepsia for releif of symptoms

Question 8

alternative for h2 antagnosit

Answer 8

PPI

Question 9

contraindications for H2 antagonist

Answer 9

renal impairment - since they are excreted by kidneys

distguise symptoms of gastric cancer

Question 10

side effects of H2 anatagonsit

Answer 10

few

bowel distrubance, headahce, dizzines

Question 11

omeprazole

Answer 11

PPI

Question 12

PPI mode of action

Answer 12

reduce gastric acid secretion, act by irreversibly inhibiting H+/K+ - ATPase in gatric parietal cells
suppress gastric acid secretion almost completely, unlike H2 antagonist

Question 13

indications for PPIs

Answer 13

preventation and treatment of peptic ulcer disease (inc NSAID caused)

symptomatic releif of dyspepsia and GORD

eradication of hpylori (+antibiotics)

Question 14

contraindications of PPIs

Answer 14

disguise gastric cancer

elderly can increase risk of fractures

Question 15

side effects of PPI

Answer 15

GI disturbances
headaches
increased risk of C diff
hypomagnesaemia

Question 16

possible interactions of PPIs

Answer 16

reduces antiplatelet effect of clopidogrel by decreasing activation by cytochrome P450 enzymes

Question 17

loperamide

Answer 17

antidiarrhoeal/antimotility drug

Question 18

mode of action of loperamide

Answer 18

agonist of opioid receptors in GI tract - reduces peristaltic contractions in gut

= transit of bwoel contents is slwoed and anal sphincter tone is increased = more time for water absorption and stool hardening

Question 19

inidcations for loperamide

Answer 19

symptomatic treatment for diarrhoea

in context of IBS and viral gastroenteritis

Question 20

contraindcations of loperamide

Answer 20

avoid in acute UC where peristalissi s may increase risk of megacolon and perforation

not used in acute blood diarrhoea (dysentry) due to possible bacterial infection

Question 21

dysentry

Answer 21

acute blood dirrhoea

Question 22

side effects of loperamide

Answer 22

few side effects

constipation, abdo cramping, flatulence

Question 23

senna

Answer 23

stimulant laxative

Question 24

mode of action of senna

Answer 24

stimulant laxatives increase water and electrolye secretion from colonic mucosa = increase vol of colonic content and stimulating perstalsis

Question 25

indications of senna

Answer 25

constipation | as suppositories for faecal imopaction

Question 26

contraindications for senna

Answer 26

stimulant laxatives not used in patients whom intestinal obstruction is suspected = insduce perforation rectal preparations sually avoided if haemorrhoids or anal fissure present

Question 27

side effects of senna

Answer 27

abdo pain or crmaping and diarrhoea prolonged use = melanosis coli (reversible pigmentation of intestinal wal

Question 28

mesalazine

Answer 28

all other variants end with salazine aminosalicylates 5ASA

Question 29

mode of action of mesalazine/ 5ASA

Answer 29

not fully understood possbily reduce release of cytokines from gut mucosa but reduece inflammation

Question 30

indications fro mesalazine

Answer 30

prevent remission of UC treat flare ups of UC some forms of arthritis crohns, but not so useful

Question 31

contraindications for mesalzine

Answer 31

renal function monitored after 3 months and 1 ear avoid in severe liver or renal impairment

Question 32

side effects of mesalazine

Answer 32

diarrhoea, nausea, vomtiing, exacerbation of colitis symptoms, headache, hpersensitivity

Question 33

metcloperamide

Answer 33

antiemetics | = dopamine D2 receptor antagonist

Question 34

mode of action of antiemetics

Answer 34

block D2 receptors = prokinetic effect, promiting gastric emptying effective in nausea and vomititng due to CTZ stimulation and reduced gut moility (due to opioids or diagbetic gastroparesiss)

Question 35

indications of antimetics

Answer 35

prophylaxis of nausea and vomtiing

Question 36

contraindications of antiemetics

Answer 36

avoid in children and young adults not in paitents with GI obstruction and perforation

Question 37

side effects of antiemetics

Answer 37

risk of extrapyramidal side effects increased when prescribed with antipsychotics should not be prescribed with dopaminergic agents for parkinsosn as will antagonise effects