Clinical Pharmacology

Question 1

What are the groups of drugs used to treat GI disease?

Answer 1

Acid suppression 
Drugs affecting GI motility 
Laxatives 
Drugs for IBD 
Drugs affecting intestinal secretions

Question 2

What are the acid suppression drugs?

Answer 2

Antacids
H2 receptor antagonists
Proton pump inhibitors

Question 3

What are the drugs affecting GI motility?

Answer 3

Anti-emetics
Anti-muscarinics
Anti-motility

Question 4

Which drugs are used to treat IBD?

Answer 4

Aminosalicylates
Corticosteroids Immunosuppressant’s
Biologics

Question 5

What do anti acids contain?

Answer 5

Magnesium or aluminium

Question 6

How do antiacids work?

Answer 6

Neutralise gastric acid

Question 7

When should anti acids be used?

Answer 7

When symptoms occur

Question 8

What is common example of a over the counter anti acid?

Answer 8

Rennie

Question 9

What is an alginates?

Answer 9

A viscous gel that floats on stomach contents and reduces reflux

Question 10

How do H2 receptor antagonists work?

Answer 10

Block histamine receptor thereby reducing acid secretion

Question 11

When are H2 receptor A indicated?

Answer 11

In GORD or peptic ulcer disease

Question 12

How are H2 receptor antagonists given?

Answer 12

Orally or IV

Question 13

How do PPI work?

Answer 13

Block proton pump and thereby reduce acid secretion

Question 14

When are PPI indicated?

Answer 14

GORD

Peptic ulcer disease

Question 15

What do pro kinetic drugs do?

Answer 15

Increase gut motility and gastric emptying

Question 16

What are pro kinetic drugs good for treating?

Answer 16

Vomiting

Question 17

Why are prokinetic drugs good for relieving vomiting?

Answer 17

Because they empty the stomach

and once food has left the stomach it cannot reflux back up

Question 18

What is the mechanism for prokinetic drugs?

Answer 18

Mechanism is unknown

but involves parasympathetic NS control of smooth muscle and sphincter tone

Question 19

What is the mechanism of drugs that decrease GI motility?

Answer 19

Operate via opiate receptors in GI tract to decrease Ach release
Decreases smooth muscle contraction
Increases anal sphincter tone

Question 20

Symptoms of which diseases can be treated with anti-spasmodics?

Answer 20

IBS

Renal colic

Question 21

What are the 4 types of laxatives?

Answer 21

Bulk
Osmotic
Stimulant
Softeners

Question 22

How do laxative work?

Answer 22

Work by increasing bulk or drawing fluid into the gut

Question 23

What do osmotic laxatives require to work?

Answer 23

Adequate fluid intake

Question 24

What are the two routes of admission for laxatives?

Answer 24

Oral

Rectal

Question 25

What drugs are given to treat IBD?

Answer 25

``` Aminosalicylates Corticosteroids Immunosuppressants Biologics Infliximab ```

Question 26

How do corticosteroids treat IBD?

Answer 26

Have anti-inflammatory effects to treat the inflammation in IBD

Question 27

How are corticosteroids given?

Answer 27

Orally IV Rectally

Question 28

What should you not do with any patient on long term steroid courses?

Answer 28

DO NOT withdraw them suddenly from treatment

Question 29

What do immunosuppressants prevent?

Answer 29

Immune cell proliferation

Question 30

What is required with the treatment with immunosuppressants?

Answer 30

Specialist use and close monitoring

Question 31

What is an example of a commonly used biologic?

Answer 31

Infliximab

Question 32

What do biologics reduce in IBD?

Answer 32

Inflammation

Question 33

Do biologics treat the undelying disease in IBD?

Answer 33

No

Question 34

What is the main adverse effect when using immunosuppressants?

Answer 34

Mainly related to bone marrow suppression

Question 35

What other conditions are biologics used in?

Answer 35

Psoriasis | Rheumatoid Arthritis

Question 36

What is the malignancy rate in the use of Infliximab?

Answer 36

1-2%

Question 37

What are the contraindications of the use of infliximab?

Answer 37

``` MS Current TB Current serious infection Pregnancy Breastfeeding ```

Question 38

What is the mechanism of cholestyramin?

Answer 38

Relieves itching from jaundice

Question 39

What is a side affect of cholestyramin?

Answer 39

Is highly bindable to other drugs

Question 40

What is ursodeoxycholic used to treat?

Answer 40

Gallstones and primary biliary cirrhosis

Question 41

How does ursodeoxycholic work?

Answer 41

Inhibits the enzyme that is involved in the formation of cholesterol

Question 42

What are the 4 stages of pharmacology?

Answer 42

Absorption Distribution Metabolism Excretion

Question 43

Is diarrhoea and constipation an acute or chronic condition?

Answer 43

Can be either

Question 44

What is the most common cause of bowel changes?

Answer 44

Antibiotic treatment

Question 45

What is the most common cause of GI bleeding?

Answer 45

Low dose aspirin

Question 46

What is the 3rd most common cause of GI bleeding?

Answer 46

Warfarin

Question 47

What are changes in gut bacteria mainly due to?

Answer 47

Use of AB

Question 48

When using Ab and experiencing diarrhoea what can lose its effectiveness?

Answer 48

OCP | so use another form of contraception if taking the pill and on AB

Question 49

What are the risk factors for hepatotoxicity?

Answer 49

Age (older) Sex (female) Alcohol consumption Genetics Malnourishment

Question 50

What is intrinsic hepatotoxicity?

Answer 50

Hepatotoxicity due to a predictable drug Is dose dependant Is an acute situation

Question 51

What is idiosyncratic hepatotoxicity?

Answer 51

Hepatotoxicity due to an unpredictable drug | Can occur at any time Not dose dependant

Question 52

What scoring system grades liver failure patients?

Answer 52

Child-Pugh classification

Question 53

What score qualifies for group A in Child-Pugh Classification?

Answer 53

<7

Question 54

What score qualifies for group b in Child-Pugh Classification?

Answer 54

7-9

Question 55

What score qualifies for group C in Child-Pugh Classification?

Answer 55

>9

Question 56

What score is often used for liver transplantation scoring?

Answer 56

Child-Pugh Classification

Question 57

What drugs will worsen encephalopathy?

Answer 57

Diuretics

Question 58

What drugs should be avoided in liver disease?

Answer 58

Warfarin/anti-coagulants Aspirin NSAIDS Opiates

Question 59

Where should you refer to for drug information?

Answer 59

BNF

Question 60

Why should opiate be avoided in liver disease patients?

Answer 60

may precipitate encephalopathy by increasing sedation