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27 Cards in this Set
- Front
- Back
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What are the symptoms of dyspepsia? (5) |
Epigastric pain Heartburn Bloating Nausea, vomiting |
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What are some of the lifestyle changes patients can make to help manage dyspepsia? (4) |
Healthy weight Smoking cessation Diet changes - less fatty foods, avoid eating 3/4 hours before going to sleep Cut down on caffeine & alcohol |
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What pharmacological methods are there for treating dyspepsia? (3) |
Antacids - aluminium hydroxide* PPIs - omeprazole*, lansoprazole* H2 receptor antagonists - ranitidine* |
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What are the symptoms of a peptic ulcer? (5) |
Epigastric pain Weight loss Dyspepsia Emergency presentation - upper GI bleed (haematemesis, melaena), acute abdomen (perforation) |
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An ulcer worse with/shortly after meals is more likely to be a... |
Gastric ulcer |
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An ulcer relieved during meals, but worse 2-3 hours later/at night is more likely to be a... |
Duodenal ulcer |
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What drug increases the risk of peptic ulcers? |
NSAIDs - aspirin, ibuprofen, naproxen |
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What is the management of peptic ulcers? |
2 x ABx and PPI - triple therapy (if H. pylori infection)
If not H. pylori infection - PPI, surgery |
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What is the specific management of H. pylori infection? |
7 day course of PPI + 1g amoxicillin + clarithromycin 500mg/metronidazole 400mg All TDS
If penicillin-allergic = PPI + clarithromycin + metronidazole |
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What is the mechanism of action of H2 receptor antagonists? |
Block the effect of histamine of the gastric parietal cell |
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What is the mechanism of action of a PPI? |
Bind to proton pump (H/K-ATPase pump) to prevent H+ ion exchange for K+ = prevent secretion of acid from parietal cell |
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What is the mechanism of action of antimotility drugs eg. loperamide* that are used to treat diarrhoea? |
Act on opioid receptors in enteric plexus to reduce motility (increase tone) |
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What are the contraindications for use of antimotility drugs in diarrhoea? (2) |
IBD Children |
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What are the adverse effects of antimotility drugs? (3) |
Nausea Vomiting Cramps |
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What is the mechanism of action of antispasmodic (antimuscarinic) drugs eg. hyoscine butylbromide* that are used to treat diarrhoea? |
Inhibit ACh = prevent transmission of parasympathetic nerve impulses = relaxation of GI smooth muscle to prevent spasms |
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What are antimuscarinic drugs indicated for use in? (2) |
Diarrhoea IBS |
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What are the contraindications to antimuscarinics? (6) |
Paralytic ileus Myasthenia gravis Pyloric stenosis Prostatic enlargement Pregnancy Breast feeding |
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What are the adverse effects of antimuscarinics? (5) |
Flatulence Bloating Heartburn Constipation Dry mouth |
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What are the 3 forms of laxatives used to treat constipation? |
Bulk-forming - eg. ispaghula husk*, methylcellulose Osmotic - eg. lactulose* Stimulant - eg. senna*, sodium docusate* |
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What is the mechanism of action of bulk-forming laxatives? |
Stimulates peristalsis by increasing stool volume |
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What is the indication for using bulk-forming laxatives? |
Constipation when passing small, hard stools |
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What are the adverse effects of bulk-forming laxatives? (2) |
Bloating Obstruction - rare |
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What is the mechanism of action of osmotic laxatives? |
Increase the water presence in the bowel (encourages osmosis) |
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What are the adverse effects of osmotic laxatives? (2) |
Cramps Flatulence |
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What is the mechanism of action of stimulant laxatives? |
Stimulate peristalsis and secretion of water and electrolytes into the gut lumen |
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What are the adverse effects of stimulant laxatives? (2) |
Cramps Atonic colon in the long term |
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What is a contraindication for the use of all laxatives? |
Risk of bowel perforation eg. intestinal obstruction |
