GI

Question 0

Which class of drugs induce GI bleeding?

Answer 0

NSAIDs

Question 1

An overdose of what drug causes acute liver cell necrosis?

Answer 1

Paracetamol

Question 2

Common drugs causing constipation:

Answer 2

Codeine

Antidepressants

Question 3

Phenytoin damages which organ ?

Answer 3

Liver

Question 4

Tetracyclines damage which organ ?

Answer 4

Liver

Question 5

Amiodarone damages which organ ?

Answer 5

Liver

Question 6

Name 4 drugs which are known to increase GOR

Answer 6

1. Anticholinergics (e.g. Ipratropium bromide)
2. Calcium channel blockers (e.g. Diltiazem)
3. Theophylline (COPD)
4. Nitrates

Question 7

Name 3 types of drugs that can induce vomiting:

Answer 7

1. Opiates (e.g. Codeine)
2. Dopamine agonist
3. Cytotoxics

Question 8

Which class of antibiotic can cause oesophageal irritation and dysphagia ?

Answer 8

Tetracyclines e.g. Doxycycline

Question 9

What drug class is Gaviscon ?

Answer 9

Antacid

Question 10

How does Gaviscon work?

Answer 10

Neutralises stomach acid, for,s raft over stomach contents to reduce reflux and protects oesophageal mucosa from regurgitation

Question 11

Contraindication of Gaviscon ?

Answer 11

Renal impairment (mg salts)
Hypophosphataemia

Question 12

Possible interactions of Gaviscon ?

Answer 12

• Decrease absorption of: ACE inhibitors, antibacterials, digoxin, iron
• increases excretion of lithium
• damages enteric coated tablets causing early induction

Question 13

What class of drug is ranitidine ? How does it work ?

Answer 13

H2 antagonist - competitively inhibits histamine actions at all H2 receptors (inc. parietal cells), therefore inhibits histamine-stimulated gastric acid secretions -> reduction in gastric acid secretion

Question 14

Indications for Gaviscon ?

Answer 14

• mild symptoms of GORD
• erosive oesophagitis heartburn
• gastric/duodenal ulcers

Question 15

Indications for ranitidine

Answer 15

• benign gastric/duodenal ulcers
• chronic episodic dyspepsia
• GORD

Question 16

Side effects of ranitidine

Answer 16

• diarrhoea
• GI/LFT disturbances
• headache/dizziness/fatigue
• rash

Question 17

Possible interactions of cimetidine ?

Answer 17

Increased concentrations of anticoagulants, phenytoin, carbamazepine, quinidine, nifedipine, theophylline
(Acts on cyp450)

Question 18

What class of drug is omeprazole ? How does it work ?

Answer 18

PPI
- works by blocking hydrogen/potassium pump ATPase enzyme in parietal cells, inhibiting the proton pump and therefore inhibiting acid secretion

Question 19

Indications for PPIs

Answer 19

• GORD
• dyspepsia
• oesophagitis
• gastric/duodenal ulcers
• H. Pylori eradication

Question 20

Contraindications of PPIs

Answer 20

• liver disease

- breast feeding/ pregnancy

Question 21

Side effects of PPIs

Answer 21

• GI disturbances
• headache
• rarely: dry mouth, peripheral oedema, pruritis

Question 22

Interactions of PPIs

Answer 22

Acts on cyp450 so increases concentrations of phenytoin, warfarin etc

Question 23

How are PPIs eliminated ?

Answer 23

80% renal

20% faecal

Question 24

What class of drug s loperamide, how does it work ?

Answer 24

Anti-diarrhoeal | - acts on opioid receptors in mesenteric plexus inhibiting Ach release - inhibits peristalsis

Question 25

Indications for loperamide ?

Answer 25

``` Acute diarrhoea Chronic diarrhoea (adults only) ```

Question 26

Contraindications of loperamide

Answer 26

- active ulcerative colitis - antibiotic associated colitis - dysentery

Question 27

Side effects of loperamide ?

Answer 27

- abdo cramps - dizziness/Fatigue - skin reactions

Question 28

Possible interactions of loperamide

Answer 28

Desmopressin

Question 29

What class of drug is Senna? How does it work ?

Answer 29

Laxative - hydrolysed in colon to produce glycoside derivatives - these directly stimulate the mesenteric plexus causing increased smooth muscle contraction

Question 30

What class of drug is mesalazine ? How does it work ?

Answer 30

Amino salicylate | - releases 5-ASA into bowel which acts as an anti-inflammatory

Question 31

Indications for mesalazine ?

Answer 31

Mild- moderate UC

Question 32

Contraindications of mesalazine?

Answer 32

Renal impairment