gi

Question 1

List examples of bulk-forming laxatives

Answer 1

Ispaghula husk

Question 2

List examples of stimulant laxatives

Answer 2

1. Bisacodyl (tab, suppositories)

2. Senna

Question 3

List examples of osmotic laxatives

Answer 3

1. Lactulose
2. Glycerol (suppositories)
3. Fleet enema

Question 4

In what situations is constipation no longer self-treatable?

Answer 4

1. Bloody, black, tarry stools
2. Constipation >2 weeks despite treatment
3. Fever
4. Nausea & vomiting
5. Marked abdominal pain/ discomfort
6. Drastic weight loss

Question 5

State the time to onset of Fybogel

Answer 5

Up to 72 hours

Question 6

State the time to onset of Lactus/ Dulphalac

Answer 6

24 to 28 hours

Question 7

State the time to onset of Fleet enema

Answer 7

2 to 5 minutes

Question 8

State the time to onset of glycerol suppositories

Answer 8

15 to 40 minutes

Question 9

State the time to onset of Senokot tablets

Answer 9

6 to 12 hours

Question 10

What are some non-pharmacological counselling points for constipation?

Answer 10

1. Ensure adequate fibre intake (2 serving of fruits and veggies per day)
2. Ensure adequate hydration (~1-2 L of water per day)

Question 11

What is the frequency of bowel movement that is considered normal?

Answer 11

• Varies; need to check with individual

- Usually ranges between 3x a week to 3x a day

Question 12

Describe the MOA of Imodium and Dhamotil

Answer 12

Binds to opiate receptors in the parietal cells of the stomach, inhibiting the release of acetylcholine and prostaglandins that reduces propulsive peristalsis and increases intestinal transit time

Question 13

In what situations is diarrhoea no longer self-treatable?

Answer 13

1. > 48 hours diarrhoea
2. Presence of blood, pus or mucus in stools
3. Severe vomiting, high fever
4. Signs of severe dehydration
5. Severe abdominal symptoms

Question 14

What P-only options are available for morning sickness in pregnant women?

Answer 14

1. Novomin (dimenhydrinate 50mg)

2. Xepagan-5 (promethazine 5mg/mL)

Question 15

List at least 3 anticholinergic side effects

Answer 15

1. Dry mouth
2. Urinary retention
3. Constipation

Question 16

State the drug class of antispasmodics

Answer 16

Weak antimuscarinics

Question 17

What is the dosing for Dhamotil?

Answer 17

Take 1 to 2 tablets three to four times a day

Question 18

What is the dosing for Imodium?

Answer 18

Take 2 capsules initially, followed by 1 capsule after every unformed stool

Question 19

What is a side effect of Smecta?

Answer 19

Constipation

Question 20

What is a side effect of activated carbon?

Answer 20

Discolouration of stools

Question 21

List 4 side effects of Imodium

Answer 21

1. Constipation
2. Nausea
3. Abdominal cramps
4. Dizziness

Question 22

Can diabetics take Lactus for constipation?

Answer 22

Yes, lactulose is not absorbed in the GI tract

Question 23

List one side effect of Motilium

Answer 23

1. Breast milk secretion
2. Drowsiness
3. QTc prolongation

Question 24

What is the maximum supply of Motilium at any one time?

Answer 24

42 tabs (i.e. max 3 tabs/day x 14 days)