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Name the causes of peptic ulcers
- Smoking, stress, genetics
- Helibacter pylori
- NSAIDS
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Discuss treatment of Peptic ulcers
- Triple therapy (2 anti biotics, 1 PPI)
- Amoxicillin
- Clarithomicin
- Omeprazole
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Describe the actions and administration and side effects of Omeprazole
- Irreversibly blocks H/K ATPase
- Single dose/daily
- Side effects: Diarrhea, farts, nausea
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Name 4 kinds of Acid suppressants
- Antacids
- Cytoprotective agents
- H2 receptor antagonists
- PPI
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Discuss 3 antacids used in acidsuppression
- Aluminum hydroxide -> s/e constipation
- Magnesium hydroxide -> s/e diarrohea
- Sodium bicarbonate -> s/e alkalosis
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Discuss 3 cytoprotective agents used in acid suppression
- Bismuth & Sucralfate: stimulate PG and HCO3; bind to ulcer base; preotect mucosa
- Misoprostol -> PGE analog
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Discuss 2 H2 receptor antagonists used inacid suppression
- Cinitidine and renitidine
- They competitively block histamine H2 receptor induced acid secretion
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State five ways to treat GORD (gastrooesophageal reflux disease)
- PPI; H2 antagonist; antacids; lifestyle changes and…modify GI motility
- Metoclopramide; Cisapride; Domperidone
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Describe mechanism of action of Metoclopramide
- Inhibits dopamine BUT increases prolactin
- Ach release
- Increases GI motility
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Describe mechanism of action of Domeperidone
- Inhibits dopamine BUT increases prolactin
- Increases Lower Esophageal Sphincter tone
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State 5 kinds of anti-emetics
- Anti cholinergic drugs
- Anti-histamine
- Anti-dopamines
- Anti-serotonins
- Cannabinoid analogs
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Discuss anti-cholinergic drugs listed under Anti-emetics. Side effects?
- Hyosine
- Muscurinic antagonist
- Works in vestibular nuclei
- Treats motion sickness
- Anticholinergic side effects
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Discuss use of anti-histamines listed underanti-emetics. Side effect?
- Cyclizine
- H1 receptor antagonist
- In vestibular nuclei
- Treats motion sickness
- S/e sedation
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Discuss use of anti-dopamines listed underanti-emetics
- Domeperidone and Metaclopramide
- Haloperidole
- Phenothiazines
- Is a H1 antagonist
- In the Chemoreceptor trigger zone
- Used in chemotherapy
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Discuss use of anti-serotonins listed underanti-emetics. Side effect?
- Ondansetron
- Depresses visceral afferent nerve fibers
- In Chemorecptor trigger zone
- Used in chemotherapy
- S/e constipation and hedach
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Discuss use of cannabinoid analogs listedunder anti-emetics. Side effect?
- Nabilone
- Mimics canabis
- Depresses Chemoreceptor trigger zone
- Used in chemotherapy
- S/e drowsiness and psycotic rxn
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Name 7 treatments for Inflammatory bowel disease
- Anti-diarrhoeas
- Laxatives
- Immunosuppresants
- Corticosteroids
- Aminosalisylates
- TNF-a inhibitors
- Anti-microbials
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Discuss anti-diarrhoea treatment in IBD
- Fluid/electrolyte balance:
- -- Oral rehydration
- Constipating agents:
- -- Kaolin
- Opiates:
- -- Diphenoxylate
- -- Loperamide (immodium)
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discuss laxative treatment in IBD
Laxatives: decrease H20 and electrolyte absorption, increase motility, increase transit
- Bulk forming laxatives:
- -- Bran
- Osmotic laxatives:
- -- Mg Sulphate, MgOH, NaPO4: avoid in renal problems; takes 1-3 hours
- -- Lactulose: takes days
- Direct stimulants of mucosa:
- -- Biscodyl supository: takes 30 minutes buddy
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State three immunosuppressants used in IBDtreatment
- Azathioprine
- Mercaptopurine (side effect = myelosuppression)
- Cyclosporine
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State 3 corticosteroids used in IBD treatment and side effects associated:
- Prednisone
- Hydrocortisone
- Budisanide
- S/e: metabolic effects, growth retardation in kids, osteoperosis
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Briefly describe the use of aminosalisilates in treatment of IBD
Inhibit leukotriene and PGs
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