Drugs used in Gastro-intestinal tract Flashcards Preview

Pharmacy Pre-Registration 20/21 > Drugs used in Gastro-intestinal tract > Flashcards

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

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

A

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
Q

Liquid paraffin- used as a lubricant for constipation

A

Not really recommended any more

Anal irritation, seepage of paraffin after prolonged use

3
Q

Sucralfate- used for gastric ulcers and gastritis

A

BEZOAR formation- stone like mass found in GI system

Caution especially in critically ill patients in intensive care or with enteral feeds

4
Q

Pancreatin- mixtures of enzymes used to aid digestion- CREON

A

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
Q

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

A

Magnesium containing = laxative effects (diarrhoea)

Aluminium containing= constipation effects

6
Q

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

A

Caution- use in DOWNS SYNDROME

Antimuscarinc side effects: (same as anticholinergic): 
Constipation
Dry mouth 
Urinary retention 
Dry skin 
Transient bradycardia
7
Q

Proton pump inhibitors can cause electrolyte disturbance

A

Hyponatreamia (reduced sodium)

8
Q

Side effects of the antidiarrhoeal drug loperamide

A

Flatulence!
Nausea
Headache

9
Q

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

A

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
Q

Stimulant laxatives side effects
Eg. Senna
Docusate sodium
Bisacodyl

A

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

11
Q

Osmotic laxative e.g. lactulose, macrogols (movicol)

Increases water in the large bowel

A

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
Q

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

A

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

13
Q

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

A

No as this may impair absorption

They can also damage the enteric coating on tablets

14
Q

When should PPIs be taken?

A

At least 30 mins before food for optimal absorption

15
Q

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?

A

Misoprostol

Used for NSAID induced ulcers

Teratogenic

16
Q

Safest PPI in pregnant women?

A

Omeprazole- only one not known to be harmful

H2 antagonists should be avoided

17
Q

Diarrhoea advice in a pregnant woman?

A

Cannot give loperamide

ORT can be used

18
Q

Safest laxative in pregnant women?

A

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

19
Q

Haemorrhoids in pregnant woman

A

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
Q

Which antiemetic drug can be purchased over the counter?

A

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
Q

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

A

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
Q

Which laxative should be used where there is faecal impaction?

A

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
Q

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

A

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
Q

When is metoclopromide contraindicated for treating sickness?

A

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

25
Q

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

A

Regular LACTULOSE

PLUS SENNA PRN/ REGULAR!!

26
Q

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

A

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
Q
Abdominal pain
Vomiting
Bloating
Constipation 
Diarrhoa

Which one is not a typical symptom of IBS?

A

Vomiting

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