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GI OTC Flashcards

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1
Q

Give some danger symptoms of a GI OTC.

A
  • Difficulty swallowing
  • Blood in vomit
  • Blood in stools
  • Vomiting with constipation
  • Unexpected weight loss
  • Alteration of bowel habits
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2
Q

What is a cause of oral thrush?

A

Candida Infection

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3
Q

Where does oral thrush usually exist?

A
  • Mouth
  • GI Tract
  • Vagina
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4
Q

What factors can cause an increase in the organisms in oral thrush?

A
  • Antibiotics
  • Diabetes
  • Pregnancy
  • Immunocompromised patients
  • Ill-fitting dentures
  • ICS
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5
Q

What are some symptoms of oral thrush?

A
  • White raised patches on oral mucosa
  • Tendency to bleed
  • Painful
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6
Q

Can babies get oral thrush?

A

Yes as their immune system is not fully developed.
-> may refuse feeds

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7
Q

What are some treatments of oral thrush?

A

Antifungal -> miconazole 20mg/g (Daktarin Oral gel)

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8
Q

What is some advice you would give a patient for oral thrush?

A
  • Maintain good oral hygiene
  • Apply treatment after food
  • Continue for 7 days after symptoms have gone
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9
Q

What is miconazole interacted with?

A
  • Warfarin
  • Sulphonylureas
  • Phenytoin
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10
Q

Which patients cannot be given miconazole?

A

Pregnant/ breast feeding/ <4 months
-> refer

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11
Q

What can dyspepsia be described as?

A
  • Indigestion
  • Heartburn
  • Wind
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12
Q

What are some causes of dyspepsia?

A
  • Hurried meals
  • Overeating
  • Spicy foods
  • Smoking
  • Medications
  • H Pylori
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13
Q

What are some symptoms of indigestion?

A
  • Epigastric discomfort after eating/drinking
  • Feeling full
  • Heartburn
  • Trapped wind
  • Nausea/vomiting
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14
Q

Give some examples of antacids.

A
  • Magnesium salts
  • Aluminium salts
  • Bismuth salts
  • Combination preparations of magnesium and aluminium
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15
Q

What is the benefit of using combination products for indigestion?

A

Involve both magnesium and aluminium.
Magnesium can cause diarrhoea and aluminium can cause constipation. Combining both products can balance out the side effects.

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16
Q

In which individuals should bismuth salts be avoided in?

A
  • Aspirin sensitive
  • Pregnant
  • <16 years old
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17
Q

Give a brand product for magnesium salts.

A

Milk of magnesia

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18
Q

Give a brand name for bismuth salts.

A

Pepto-Bismol

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19
Q

What are some combination products of antacids?

A
  • Kolanticon Gel
  • Co-magaldrox
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20
Q

What are some other treatments for indigestion other than antacids and explain each?

A

Activated dimeticone
- antifoaming agent
- reduces surface tension of gas bubbles
Alginates
- Treat acid reflux
- raft

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21
Q

Give some brand names for activated dimeticones?

A
  • Settlers Windeze
  • Deflatine
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22
Q

Give a brand name for alginates.

A
  • Gaviscon
  • Peptac
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23
Q

What drugs can interact with antacids?

A
  • Digoxin
  • Warfarin
  • Enteric coated tablets
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24
Q

Give a treatment for indigestion other than antacids, activated dimeticone and alginates.

A

Proton pump inhibitors
-> Esomeprazole 20mg tablets

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25
How long is PPIs taken for the treatment of indigestion?
Up to 2 weeks -> no improvement -> refer
26
Give a brand name for a PPI indigestion treatment.
Nexium
27
What is some counselling given to a patient with indigestion?
- Small regular meals - Avoid meals late at night - Avoid spicy foods - Take antacids 1 hour before food
28
When should a patient with indigestion be referred?
1st time dyspepsia 45+ For endoscopy: >55 with alarm symptoms - persistent vomiting - loss of appetite - difficulty swallowing - feeling of lump in throat - GI bleeding
29
What is IBS cause by?
Unknown Could be stress or food intolerances.
30
What are some symptoms of IBS?
- Alternating constipation/diarrhoea - Abdominal pain - Bloating - Rectal fullness/incomplete evacuation - Nausea
31
When must treatment for IBS only be given?
If the condition has been diagnosed by a Dr.
32
What should drug treatment for IBS be based on?
The major presenting symptoms -> abdominal pain, constipation, diarrhoea
33
What are the 3 treatment options for IBS and what do they do?
- Anti-spasmodic: relax smooth muscle - Anti-diarrhoeal: decrease bowel motility and reduce stool frequency - Bulking agent: improve constipation and diarrhoea
34
Give some anti-spasmodic drugs and brands.
- Mebeverine (colofac IBS) - Hyoscine butylbromide (Buscopan IBS) - Peppermint oil (Colpermin)
35
Give an anti-diarrhoeal drug and brand.
Loperamide (Imodium)
36
Give a bulking agent and a brand.
Ispaghula Husk (Senokot High Fibre)
37
What is some counselling given to a patient with IBS?
- Check medications - Balanced diet with plenty of fluids - Regular exercise - Stress management
38
When should you refer a patient with IBS?
- Blood in stool - Not diagnosed previously by doctor - Fever - Weight loss
39
What are some causes of constipation?
- Reduced fluid intake - Lack of exercise - Medication - IBS - Refusing to go to the toilet
40
What are some symptoms of constipation?
- Decrease in frequency of bowel movement (compared to normal bowel habits) - Hard stools - Straining
41
What is first line treatment for constipation?
Alter diet and increase fluid intake
42
State some constipation treatments.
- Bulk laxatives - Stimulant laxatives - Osmotic laxatives - Faecal softeners
43
Give a brand name for bulk laxatives.
Isphagula Husk
44
Which individuals should bulk laxatives not be given in?
Frail elderly
45
How do stimulant laxatives work?
Stimulate nerve endings in the intestinal walls.
46
Give a drug and brand name for a stimulant laxatives.
Anthraquinones: senna (Senokot) Diphenylmethane derivatives: - Bisacodyl (Dulcolax tablets + supps) - Sodium picosulphate (Dulcolax - Pico)
47
What are the restrictions on the OTC of stimulant laxatives?
GSL - 18+ P - 12+ Pack size limitations Short-term use only
48
How do osmotic laxatives work?
Retain fluid in bowels which stimulates peristalsis and forms loose stools
49
Give a drug and brand names for osmotic laxatives.
Magnesium salts: - Magnesium sulphate (Epsom salts) - Magnesium hydroxide (Magnesium trisilicate mixture) Macrogol (polyethylene glycol)/lactulose Glycerol (Glycerin suppositories)
50
What is macrogol/lactulose contraindicated in?
People who are lactose intolerant
51
Give a drug and brand of faecal softeners.
Docusate sodium (Dioctyl caps)
52
True or False: Bulk laxatives cannot be taken at bedtime.
True
53
Which type of treatment would be most suitable for individuals who are pregnant/breast feeding?
- Bulk forming and lactulose -> Stimulant laxatives are contraindicated
54
When would you refer a patient with constipation?
- Illness and unable to work - Blood in stool - Continuous severe pain lasting more than 2 days - Weight loss - Diarrhoea - Nausea/vomiting - Self medication not effective
55
What some causes of diarrhoea?
- Bacterial/viral - Diet changes - Medication - Food allergies - IBS - Stress
56
What can be given to a patient for the treatment of diarrhoea?
Rehydration sachets Anti-diarrhoeals
57
Give a drug name and brand name of treatment of diarrhoea for rehydration.
Oral rehydration sachets (Dioralyte)
58
Give a drug name and brand name of treatment of diarrhoea for anti-diarrhoeal.
Loperamide (Imodium caps) Bismuth Salicylate (Pepto-Bismol)
59
What is the age for taking loperamide?
12+
60
What is Bismuth Salicylate contraindicated in?
If allergic to aspirin
61
When should a patient with diarrhoea be referred?
- Elderly if >48 hours - Chronic/recurrent - Fatigue/pain >2 days - Weight loss - Blood in stools - Persistent mucus in stools - Symptoms change/worsen - Alternating diarrhoea/constipation

PHA223 (24 decks)

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