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21 Cards in this Set
- Front
- Back
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What is IBS? |
Common, chronic, relapsing and often life long condition mainly affecting people 20-30 years old. More common in women |
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What are the symptoms of IBS? |
Lower abdominal pain Bloating Alternative diarrhoea and constipation Passage of mucus Aggregated by stress, depression, anxiety, lack of dietary fibre |
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Lifestyle advise for IBS |
Increase physical activity Eat regularly without missing meals or leaving long gaps between meals Diet - limit fresh fruit to no more than 3 portions a day Fibre intake should be reviewed - if need an increase soluble fibre e.g isphagula husk or foods high in soluble fibre like oats. Reduce insoluble fibre e.g bran - can exacerbate symptoms Drink 8 cups of water a day Avoid Artificial sweetener sorbitol in patients with diarrhoea When having probiotics continue for at least 4 weeks while monitoring the effects - mainly for diarrhoea and/ or bloating |
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What is drug treatment for IBS? |
1. Antispasmodic- gi spasms. Less likely to cause adverse effects compared to antimuscarinics Alverine Mebeverine Peppermint oil - heart burn, local irritation of mouth/oesophagus 2. Antimuscarinics - gi spasms Hyoscone butylbromide Atropine Dicycloverine 3. Laxatives - constipation Lactulose NOT recommended as causes bloating Linoclotide - unresponsive to different laxative classes and had constipation for 12 months. Taken once daily and at least 30 mins before meal 4. Antimotility - diarrhoea Loperamide 5. Antidepressant - 2nd line for abdominal pain/discomfort Tca - Amitriptyline 5-10mg at night and titrating dose up in steps of 10mg at least every 2 weeks. Max dose 30mg at night Ssri Citalopram - 10-20mg daily Fluoxetine - 20mg daily |
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What is brand name of mebeverine with isphagula husk? |
Fybogel mebeverine P med |
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What are the danger symptoms of IBS? |
1.Rectal bleeding associated with change in bowel habit 2. Blood mixed in with stools |
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What is the age for fybogel mebeverine |
12+ Stop use after 2 weeks |
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How long should they take fybogel mebeverine for? |
Don’t take immediately before bed Take half and hour to an hour before or after taking other meds |
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How long do bulk forming laxatives take to work? |
2-3 days |
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When shouldn’t you prescribe laxatives |
1. Intestinal obstruction/ perforation 2. Paralytic ileus 3. Colonic atony or faecal impaction 4. Crohns or ulcerative colitis 5. Toxic mega colon |
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What are the adverse effects of bulk forming laxatives? |
Flatulence and bloating Excessive dose/inadequate fluid intake may cause intestinal obstruction Excess laxative dose may cause diarrhoea- if prolonged may cause electrolyte disturbances e.g hypokalemia |
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Which patients shouldn’t be prescribed loperamide? |
Acute uc Antibiotic associated colitis Condition where andominal distension occurs |
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What are the cautions of loperamide? |
Hepatic impairment Due to reduced first pass metabolism and risk of hepatic accumulation |
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What are the adverse effects of loperamide? |
Dizziness Headache Flatulence Nausea Abdominal pain Dry mouth Dyspepsia Dry mouth |
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What is the dose of mebeverine and when should it be taken? |
135-150mg 3 times a day Take 20 mins before meals for immediate release 200mg twice a day for modified release |
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What otc meds are available for IBS? |
1. Colpermin IBS relief - peppermint oil 2. Spasmonal 60mg hard capsules 3. Colofac ibs 135mg - mebeverine 4. Buscopan IBS relief - hyoscine butylbromide |
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How should colpermin IBS relief tabs be taken? |
Should be taken until symptoms resolve (usually within 1-2 weeks) Treatment can be continued for 2-3 months 1 capsule, three times a day |
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When should patients stop taking colpermin IBS relief? |
Patients who already suffer from heartburn - sometimes heartburn is exacerbated after taking colpermin. Discontinue use Contains arachis oil (peanut oil) - avoid in patients with peanut or soya allergy |
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How should colofac IBS be taken? |
1 tab 3 times a day Preferably 20 mins before meal If symptoms persist for longer than 2 weeks - refer |
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What age can use colofac IBS? |
18+ |
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What is age for buscopan IBS? |
12+ |
