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Flashcards in GI drugs Deck (15):
1

Which drugs can cause constipation?

1) Opiates
2) Calcium channel blockers
3) Anticholinergic drugs (benzhexol, tricyclic antidepressants)
4) Iron
5) Lithium

2

What is the main treatment for constipation?

Non-pharmacological treatment is preferred.

Increase fibre in diet
Increase fluid intake
Exercise

3

What is the recommended amount of dietary fibre per day?

18g

4

What are the 4 classes of pharmacological treatment for constipation?

1) Bulk forming laxatives e.g. ispaghula husk
2) Osmotic laxatives e.g. Mg salts, lactulose
3) Stimulants e.g. Senna
4) Stool softeners e.g. arachis oil

5

How do we treat diarrhoea?

1) Rehydrate with oral rehydration therapy (e.g. dioralyte)
2) If volume deplete use IV fluids that will replace sodium and potassium (Saline with added K+ and dextrose).

If infective:
Treat with antibiotics: ciprofloxacin, metronidazole, vancomycin.

Loperamide is an opiate that reduces diarrhoea (but can cause constipation).

6

What drugs can cause diarrhoea?

Laxatives
Antibiotics
SSRIs
Orlistat (causes fat malabsorption, used in obesity)

7

How do we treat IBS?

If constipation- dietary fibre and laxatives
If diarrhoea- loperamide (opiate).

Psychological approach can be useful in certain cases.

Give muscle relaxants to reduce pain- have variable results:
Antimuscarinics (propantheline), direct acting relaxant (mebeverine, peppermint oil)

8

How do we treat IBD acutely?

Acutely: IV fluids

Specific treatment: systemic steroids, aminosalicylates (e.g. sulphazalazine, mesalazine, olsalazine).

9

How do we treat IBD long term?

Aminosalicylates (topically or systemically)
AVOID long term steroids
Give steroid sparing drugs (e.g. methotrexate, azathioprine in Crohns. azothioprine, ciclosporin in UC).

Infliximab may be used for both (this is an anti-TNFa)- Crohn's for disease resistant treatment and to maintain remissions.
UC for acute exacerbations that are not settling with conventional therapy.

10

What drugs cause dyspepsia?

NSAIDs
Corticosteroids
CCBs
Bisphosphonates
Nitrates
Theophyllines

11

What upper GI tract diseases are associated with H. Pylori?

Peptic ulcer disease
Chronic gastritis
Gastric adenocarcinoma
B lymphoma

12

Name 3 dopamine antagonist drugs (anti-emetic)?

Dom Peridone
Metoclopramide
Prochlorperazine

13

What kind of anti-emetic would you give for vertigo?

Anti-histamine

14

What kind of anti-emetic would you give for motion sickness?

Anticholinergics (e.g. hyoscine bromide)

15

What kind of anti-emetic would you give for nausea and vomiting SE of morphine use?

Anticholinergics