Drugs used in Gastro-intestinal tract Flashcards Preview

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Flashcards in Drugs used in Gastro-intestinal tract Deck (27)
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1

Aminosalicylates, anti-inflammatory drugs used in ulcerative colitis, eg sulfasalazine, mesalazine

REPORTING: Blood dyscrasias- sore throat, fever, rash, ulcers, bleeding

Mesalazine: switching brands- advise to report any changes in symptoms

Sulfasalazine: colours body fluids orange/yellow

2

Liquid paraffin- used as a lubricant for constipation

Not really recommended any more
Anal irritation, seepage of paraffin after prolonged use

3

Sucralfate- used for gastric ulcers and gastritis

BEZOAR formation- stone like mass found in GI system
Caution especially in critically ill patients in intensive care or with enteral feeds

4

Pancreatin- mixtures of enzymes used to aid digestion- CREON

Advise patients to maintain adequate hydration at high doses
Also advise that the capsules should be swallowed whole and not chewed due to an enteric coating.
Used in Cystic fibrosis

5

Magnesium containing antacids can have opposite side effects to those containing aluminium

Magnesium containing = laxative effects (diarrhoea)

Aluminium containing= constipation effects

6

Antimuscarinics e.g. atropine, hyoscine butylbromide (buscopan) used to reduce gastric motility

Caution- use in DOWNS SYNDROME

Antimuscarinc side effects: (same as anticholinergic):
Constipation
Dry mouth
Urinary retention
Dry skin
Transient bradycardia

7

Proton pump inhibitors can cause electrolyte disturbance

Hyponatreamia (reduced sodium)

8

Side effects of the antidiarrhoeal drug loperamide

Flatulence!
Nausea
Headache

9

Side effects of bulk forming laxatives? Eg isoaghula husk (fybogel)

Flatulence
Abdominal distension (bloating)
These swell in contact with liquid and therefore advise to take with plenty of water and not to take immediately before bed

10

Stimulant laxatives side effects
Eg. Senna
Docusate sodium
Bisacodyl

Abdominal cramps
Diarrhoea if used in excess
Often abused to lose weight

11

Osmotic laxative e.g. lactulose, macrogols (movicol)
Increases water in the large bowel

Need patient to drink adequate amount of water for them to work
Can take 3 days to work
Nausea, vomitting, cramps, bloating, flatulence all side effects

12

What do the words "low Na+" on antacid preparations indicate?

Sodium content of less than 1mmol per tablet or 10ml dose. This is written on for people with hypertension

13

Should antacids be taken at the same time as other drugs?

No as this may impair absorption
They can also damage the enteric coating on tablets

14

When should PPIs be taken?

At least 30 mins before food for optimal absorption

15

What drug, used for GI ulcers, should be avoided in all trimesters of pregnancy and in women of a child bearing age unless absolutely necessary?

Misoprostol

Used for NSAID induced ulcers

Teratogenic

16

Safest PPI in pregnant women?

Omeprazole- only one not known to be harmful
H2 antagonists should be avoided

17

Diarrhoea advice in a pregnant woman?

Cannot give loperamide
ORT can be used

18

Safest laxative in pregnant women?

Bulk forming laxatives most appropriate- ispaghula husk I.e. Fybogel
Lactulose probably not harmful
Avoid stimulants and macrogols

19

Haemorrhoids in pregnant woman

Avoid steroid based preparations- e.g. Preparation H containing hydrocortisone

Local therapies may be used: germaloids cream or ointment or suppositories but NOT the spray

20

Which antiemetic drug can be purchased over the counter?

Cyclizine (antihistamine)

Metoclopramide and Domperidone no longer OTC: Metoclopromide risk in Parkinsons, Domperidone with QT prolongation effects so cardiac risks.

Can recommend Peptobismol to settle stomach but not very nice, and travel sickness tablets available.

21

What laxative and what anti-emetic are recommended for use in terminally ill patients?

Laxative- co-danthromer/ co-danthrusate (can colour urine red)

It is locally irritant- avoid contact with skin

Anti-emetic: Ondansetron, Haloperidol- these are good for opioid induce N&V.
(Haloperidol also used first line for delirium in palliative care- this is very common)

22

Which laxative should be used where there is faecal impaction?

impacted colon, your feces become dry and won’t budge, making it impossible to excrete them from your body

Should therefore use the OSMOTIC laxative to get water into the stool: MACROGOL (movicol) is used

23

What is the most common side effect of VERAPAMIL (rate limiting CCB)?

Constipation!
Does not appear to be an issue with any of the other CCB's just Verapamil

Verapamil has a more profound effect on gut smooth muscle than the other calcium channel antagonists. It reduces gut motility and causes constipation.

24

When is metoclopromide contraindicated for treating sickness?

3 - 4 days after Gastrointestinal surgery
GI heamorrhage
GI obstruction
Under 18 years due to neurological effects

25

Which laxatives do we use in opioid induced constipation/ immobility (e.g. due to hospital stay)?

Regular LACTULOSE
PLUS SENNA PRN/ REGULAR!!

26

What is Colestipol? When should other medications be taken in relation to this drug?

A bile acid sequestrant used to lower cholesterol (LDL specifically)

Take other medication 1 hour before or 4 hours after this medication as it can effect absorption

27

Abdominal pain
Vomiting
Bloating
Constipation
Diarrhoa

Which one is not a typical symptom of IBS?

Vomiting