lecture 4

Question 1

when to refer GI problems

Answer 1

prolonged, severe, unresponsive to therapy, danger symptoms

Question 2

Alginate examples

Answer 2

peptac, gaviscon (rafting agents)

Question 3

antacid examples

Answer 3

magaldrox, magnesium trisikicate

Question 4

What to watch with alginates+ antacids

Answer 4

d/i (drug interactions and chelation) and they also all contain sodium - so care needs taken when pt has heart problems/ kidney failure

Question 5

how do alginates work

Answer 5

they stop acid from entering the wrong place ( but they dont stop the production) by forming a physical barrier on top of stomach contents

Question 6

fast acting antacids vs slow acting and their effect

Answer 6

Mg is fast acting - can cause diarrhoea
Aluminium hydroxide is slow acting - can cause constipation

Question 7

Ca in antacids is a problem, how?

Answer 7

interacts with antibiotics eg lymecycline and doxycycline

Question 8

PPIs eg

Answer 8

Omeprazole, lansoprazole, esomeprazole, pantoprazolem rabeprazole

Question 9

esomeprazole is what form of omeprazole

Answer 9

active

Question 10

lanzoprazole side effect

Answer 10

bone thining ( caution in pt with transplants/ pregnancy)

Question 11

which PPI do patients at risk of stroke need to be wary of and why

Answer 11

omeprazole/esomeprazole - decreases the antiplatelet effects (clopidogrel)

Question 12

PPI caution s

Answer 12

bone fracture in prolonged use, increased c diff risk, masks cancer symptoms, rebound hyper secretion when you stop taking them

Question 13

which PPI should people on warfarin be wary of

Answer 13

pantoprazole - increases the anticoagulant effect

Question 14

PPI side effects

Answer 14

abdominal pain and headaches - commmon
arthralgia, parasthesia - uncommon
confusion, gynaecomastia - rare

Question 15

H2 receptor antagonists

Answer 15

ranitidine, cimetidine, famotidine , nizatidine

Question 16

caution with cimetidine

Answer 16

interacts with lots of drugs because of hepatic cytochrome p450 effect - slows the metabolism of some drugs , gynaecomastia in males, increases blood conc of erythromycin

Question 17

h2 receptor antagonists side effects

Answer 17

can mask cancer symptoms, diarrhoea and dizziness(common), erythema (uncommon), hepatitis and confusion (rare)

Question 18

which drugs reduce plasma conc of atazanavir

Answer 18

famotidine/ranitidine

Question 19

chaletes and complexes eg

Answer 19

sucralfate, tripotassium, dicitratobismuthate - forms a barrier over the ulcer to promote healing

Question 20

prostaglandin alalogue eg

Answer 20

misoprostol - have antisecretory properties and cytoprotection to maintain integrity of the mucosal lining

Question 21

pro kinetic drugs eg

Answer 21

metoclopramide, domperidone - these get stiff through the stomach more quickly so that there is no damage

Question 22

how to use drugs to treat h pylori associated issues

Answer 22

3 diff drugs high dose for a week- might feel nauseous but encourage them to stick with it as resistance will occur if not then lower the dose for maintanance and remove the antibacterial