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BNF 72/74 > Chapter 1- GI System > Flashcards

Chapter 1- GI System Flashcards

1
Q

Name 7 antibiotics that can cause C Diff infection

A 
Ampicillin 
Amoxicillin 
Co-amoxiclav
2nd gen cephalosporins
3rd gen cephalosporins
Clindamycin 
Quinolones
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2
Q

Name three treatment options for C Diff

A

Metronidazole
Vancomycin
Fidaxomicin

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3
Q

Name two chronic inflammatory bowel diseases

A

Ulcerative colitis

Crohn’s disease

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4
Q

Name three classes of drug used to treat inflammatory bowel diseases

A

Aminosalicylates
Corticosteroids
Immune response drugs

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5
Q

Name four aminosalicylates used in IBS

A

Balsalazide
Mesalazine
Olsalazine
Sulfasalazine

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6
Q

Name four corticosteroids used in IBS

A

Hydrocortisone
Beclometasone
Budesonide
Prednisone

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7
Q

Name four drugs used in IBS that effect the immune system

A

Ciclosporin
Azathioprine
Mercaptopurine
Methotrexate

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8
Q

Name four monoclonal antibodies used in IBS

A

Infliximab
Adalimumab
Golimumab
Vedolizumab

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9
Q

MOA of colestyramine and why is it used in IBS

A

Binds bile salts- can get loss of bile salt absorption in IBS

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10
Q

Abuse of laxatives can lead to what?

A

Hypokalaemia

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11
Q

Name 5 classes of laxatives

A 
Bulk forming 
Stimulants 
Faecal softeners
Osmotic laxatives 
Other
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12
Q

Stimulant laxatives can cause what?

A

Abdominal cramps

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13
Q

Which antacids are constipating

A

Aluminium containing

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14
Q

Which antacids are laxatives

A

Magnesium containing

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15
Q

How do you treat H.pylori

A

One week triple therapy:
PPI
Clarithromycin
Amoxicillin or metronidazole

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16
Q

What’s the MHRA warning for PPIs?

A

Low risk of subacute cutaneous lupus erythematosus

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17
Q

Why can antimuscarinics/anticholinergics be used in IBS?

A

They reduce intestinal motility

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18
Q

What is diverticular disease?

A

Where the diverticula (sac like protrusions of mucosa through the muscular colonic wall) cause intermittent lower abdominal pain in absence of inflammation/infection

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19
Q

What is diverticulitis?

A

When the diverticula become inflamed and infected

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20
Q

True or false: peppermint oil can irritate the mouth or oesophagus

A

TRUE so don’t chew or break the capsules

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21
Q

When are bulk forming laxatives appropriate?

A

When the diet is deficient in fibre

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22
Q

When are stimulant laxatives appropriate

A

To increase intestinal motility

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23
Q

How does linaclotide work

A

Increases intestinal fluid secretion and transit, and decreases visceral pain

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24
Q

How do antimotility drugs work

A

Bind to opioid receptors in the GI tract and therefore prolong the duration of intestinal transit

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25
Name two potentially carcinogenic stimulant laxatives
Co-danthramer | Co-danthrusate
26
What laxative can be used to treat hepatic encephalopathy and why
Lactulose- it discourages the proliferation of ammonia-producing organisms
27
Which laxative should be swallowed with plenty of water and should not be taken before bedtime
Ispaghula husk
28
Why are bismuth containing antacid products (unless chelates) not recommended
Absorbed bismuth can be neurotoxic, causing encephalopathy; they can be constipating
29
Calcium containing antacids can induce what?
Rebound acid secretion
30
Prolonged high doses of calcium containing antacids can cause what
Hypercalcaemia and alkalosis and can precipitate the milk-alkali syndrome
31
What is simeticone
Activated dimeticone is added to an antacid as an antifoaming agent to relieve flatulence
32
What preparation may be useful for the relief of hiccup in palliative care
Simeticone
33
What gastroprotective complex/chelator has been associated with bezoar formation?
Sucralfate
34
List indications for antimuscarinic drugs
``` Arrhythmias Asthma and airway disease Motion sickness Parkinsonism Urinary incontinence Mydriasis & cycloplegia Premedication Antidote to organophosphorous poisoning ```
35
What's the predominant primary bile acid in humans?
Cholic acid
36
What is linaclotide
Guanylate Cyclase-C receptor agonist laxative used in moderate to severe IBS with constipation
37
How do bulk forming laxatives work
Relieve constipation by increasing faecal mass which stimulates peristalsis
38
Which type of laxative needs adequate fluid intake to avoid intestinal obstruction
Ispaghula husk
39
True or false: ispaghula husk should be taken just before going to bed
FALSE
40
How does lubiprostone work
Is a chloride channel activator that acts locally in the gut to increase intestinal fluid secretion and intestinal motility (=laxative effect)
41
MOA of prucalopride
A selective serotonin 5HT4 receptor agonist with prokinetic properties
42
True or false: bisacodyl is an osmotic laxative
False it's a stimulant
43
Co-danthramer stimulant laxative can make your urine blue: true or false?
False- can make it red
44
What component of the metabolised sennisides from senna stimulates peristalsis?
The anthrone component
45
What type of laxative is sodium picosulfate
Stimulant
46
True or false: loperamide acts on opioid receptors in the GI tract and does not readily cross the BBB
True
47
Name an enkephalinase inhibitor used in the treatment of diarrhoea
Racecadotril
48
True or false: antacids can damage enteric coatings designed to prevent dissolution in the stomach
True!
49
Tripotassium dicitratobismuthate is a gastroprotective complex/chelate that can cause what two things?
Darkened tongue and blackened faeces
50
True or false: PPIs can increase the risk of fractures but do not increase the risk of GI infections
False they increase the risk of both fractures and GI infections
51
PPIs can cause hypomagnesaemia true or false?
True
52
Symptoms of dyspepsia
``` Upper abdominal pain Fullness Early satiety Bloating Nausea ```
53
Alarm features with dyspepsia?
``` Bleeding Dysphagia Recurrent vomiting Weight loss >55 yrs with unexplained recent onset dyspepsia ```
54
Symptoms of gastro-oesophageal reflux disease (GORD)
``` Heartburn Acid regurgitation Dysphasia Oesophagitis Ulceration ```
55
Treatment for GORD in pregnancy
1) lifestyle 2) antacids 3) Ranitidine 4) PPI
56
Treatment of GORD in normal patients (I.e not pregs)
1) lifestyle 2) antacids 3) PPI 4) H2 receptor antagonist
57
Treatment of GORD in children
1) feed thickener or alteration in feed frequency 2) alginate 3) specialist
58
Gaviscon and peptic contain what three ingredients
Sodium alginate Sodium bicarbonate Calcium carbonate
59
What makes gaviscon advance?
Also contains potassium bicarbonate
60
Main aim of treating diarrhoea
Prevent or reverse electrolyte and fluid depletion
61
Three main categories of medication to treat ulcerative colitis and crohns
Aminosalicylates (meslazine, sulfasalazine) Azathiopurine/mercaptopurine Corticosteroids
62
Side effects of long term corticosteroids include what three things?
Osteoporosis Hypertension Diabetes
63
Counselling for aminosalicylates
Report any: bruising, bleeding, fever, sore throat, malaise | Orange/yellow staining of body fluids
64
Which type of fibre is better in IBS and give an example
Soluble fibre such as oats rather than insoluble such as bran
65
How long does senna take to work?
8-12 hrs
66
How long does bisacodyl take to work
10-12 hrs
67
How long does docusate take to work
24-48 hrs
68
How long does lactulose take to work
48 hrs
69
How long does ispaghula husk take to work
Few days
70
What is arachais oil
Faecal softener- peanut oil
71
First line treatment of rectal problems e.g haemorrhoids
Soothing - zinc oxide Pain relief - lidocaine Combination preps - corticosteroids + anaesthetic
72
What diuretic would you give if someone has a stoma
Potassium sparing due to risk of losing electrolytes
73
Is colestyramine absorbed in the GI tract?
No
74
Counselling points for pancreatin
Inactivated by gastric acid so take with or just after fluid Take with plenty of fluid
75
Fat soluble vitamins include:
D E A K

BNF 72/74 (17 decks)

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