Gi

Question 1

Gaviscon

Answer 1

Alginate and antacid, buffers stomach acid and increases stomach content viscosity and reduces reflux

Question 2

S/E antacids and alginates

Answer 2

Mg causes D and Aluminium causes constipation

Question 3

Lansoprazole and omeprazole

Answer 3

PPI- irreversibly inhibit H/K ATPase in parietal cells. Final stage so significant reduction in acid secretion

Question 4

S/E PPI

Answer 4

Mask symptoms of gastro oesophageal cancer. Fracture risk. Also O is a CYP inhibitor

Question 5

Ranitidine

Answer 5

H2 receptor antagonist so less proton pump activation. Only partial

Question 6

S/E H2 antagonist

Answer 6

Mask symptoms of cancer. Renal impairment. Not to use with antivirals as reduce exposure. ? carcinogenic contaminant

Question 7

Mesalazine and used to treat

Answer 7

Aminosalicylate- release of 5 aminosalicylic acid.Treat ulcerative colitis

Question 8

S/E aminosalicylate

Answer 8

Gi upset

Question 9

What drugs are of concern when prescribing PPI

Answer 9

Phenytoin, warfarin and clopidogrel as CYP issues

Question 10

Why do PPI give greater protection that H2 antag

Answer 10

Bind to end of pathway.

Question 11

Agents that work of vestibular nucleus

Answer 11

Muscarinic receptor antagonist and H1 receptor antagonists

Question 12

Hyoscine hydrobromide

Answer 12

Muscarinic receptor antagonist- block muscarinic ACh receptors in CTZ and vestibular nucleus

Question 13

S/E muscarinic antagonist

Answer 13

Sedation, memory issues, glaucoma, constipation

Question 14

Cyclizine

Answer 14

H1 receptor antagonist- good for motion sickness. Not for kids and old as confusion

Question 15

Agents that work on visceral afferents in gut

Answer 15

5HT3 receptor antagonist and D2 receptor antagonist

Question 16

What is 5HT

Answer 16

Serotonin

Question 17

Ondansetron

Answer 17

5HT3 receptor antagonist- reduced mobility and GI secretions and centrally inhibits CTZ

Question 18

Metoclopramide

Answer 18

D2 receptor antagonist- Increases ACh at receptors in gut. Promotes gastric emptying. Increases peristalsis

Question 19

What is metoclopramide good for

Answer 19

Gout and illeus

Question 20

S/E 5HT3 antagonist

Answer 20

Constipation, headache, Long QT syndrome, parkinsonism

Question 21

S/E D2 antagonists

Answer 21

Galactorrhoea, dystonia and parkinsonism.

Question 22

Other use for domperidone

Answer 22

Increase lactation in breastfeeding mothers

Question 23

Agents acting on CTZ

Answer 23

D2 receptor antagonists, corticosteroids, cannabinoids, neurokinin 1 receptor antagonists

Question 24

D2 antagonist working on CTZ

Answer 24

Haloperidol

Question 25

Corticosteroids

Answer 25

Dexamethasone

Question 26

S/E corticosteroids

Answer 26

Insomnia, increased BM and appetite

Question 27

Nabilone

Answer 27

Cannabinoids- last line treatment

Question 28

Aprepitant

Answer 28

Neurokinin 1 receptor antagonist, prevents action of substance P at CTZ and peripheral nerves. Boost effects of 5HT3 receptor antagonist.

Question 29

Domperidone, metoclopramide

Answer 29

Prokinetic. GORD, Ileus

Question 30

Risk of prokinetic

Answer 30

Obstruction and risk of perforation

Question 31

Treat hyperemesis gtavidarum

Answer 31

Promethazine or Prochlorperazine (H1 and D2 antag)

Question 32

Risk for post op nausea

Answer 32

Female, non smoker, young, laparoscopic

Question 33

Loperamide, codeine, morphine

Answer 33

Opioid receptor agonist, decreases tone of long and circu smooth muscle. Reduces peristalsis, increases segmental contractions

Question 34

S/E opioid receptor agonist

Answer 34

Paralytic ileus, n and v, sedation and addiction

Question 35

Constipating diet

Answer 35

Bananas, white bread, white rice

Question 36

Lactulose and movicol

Answer 36

Osmotic laxative. Lactulose draws in and macrogols retain fluid they came with

Question 37

Senna

Answer 37

Stimulant laxative- increase intestinal motility.

Question 38

Docusate sodium

Answer 38

Stool softeners, decrease surface tension of stool. Increase penetration of fluid in stool.