J4.iii · GI Motility Drugs

This viva tested knowledge of respiratory physiology including lung volumes and changes with obesity. It then went on to discuss physiology of the lower oesophageal sphincter and gastric emptying .It went to cover the pharmacology of metoclopramide.

This Viva explored knowledge of the physiology of swallowing and the passage of food through the oesophagus. It began by discussing the stages of swallowing, and then moved on to the cough reflex, the lower oesophageal sphincter and metoclopramide. Most candidates had a good knowledge of swallowing, but were less informed about the cough reflex and innervation of the larynx.

The initial information given to the candidates was - This station is mostly concerned with the pharmacology of drugs acting on the gastrointestinal tract. What is a prokinetic? This viva explored the candidates’ knowledge in relation to the following points Prokinetics, examples of prokinetics, mechanism of action, general pharmacology of metoclopramide GIT secretions Laxatives, mechanism of action of lactulose Octreotide, mechanism of action, general pharmacology, indications for use Examination feedback: This is an important, and potentially overlooked, area of clinical ICU practice. Candidates breadth and depth of knowledge for this important topic was lower than expected. In particular was mechanism of action of prokinetics, laxatives (of which most of the discussion centred around lactulose) and octreotide.