GI

Question 1

Key drugs that can worsen GERD symptoms

Answer 1

• Aspirins/NSAIDs
• Bisphosphonates
• dabigatran
• estrogen products
• fish oil products
• iron supplements
• nicotine replacement therapy
• steroids
• tetracycline

Question 2

calcium carbonate

Answer 2

tums
w/ mag- mylanta
w/ simethicon anti-gas is maalox advanced max strength lol
- antacids

Question 3

magnesium hydroxide

Answer 3

milk of magnesia
- antacids

Question 4

sodium carbonate/aspirin/citric acid

Answer 4

alka-seltzer
- antacids

Question 5

antacid notes:

Answer 5

aluminum and mag: can accumulate and several renal dysfunction….
Ca- constipation SE
Al- constipation SE
mag- loose stools SE

Question 6

famotidine

Answer 6

pepcid Ac, zantac 360
<60 ml/min decreased dose
- H2RA

Question 7

ranitidine

Answer 7

Zantac
all produced removed april 2020
- H2RA

Question 8

cimetidine

Answer 8

tagamet
high dose: gynecomastia, impotence
- H2RA

Question 9

antacid >2 years

Answer 9

vitamin b12 deficiency

Question 10

esomeprazole

Answer 10

nexium
- PPI

Question 11

lansoprazole

Answer 11

Prevacid
- PPI

Question 12

omeprazole

Answer 12

Prilosec
- PPI

Question 13

dexlansoprazole

Answer 13

Dexilant
- PPI

Question 14

pantoprazole

Answer 14

Protonix
- PPI

Question 15

PPIs

Answer 15

• no longer the 8 weeks use recommend
• Vitamin B12 deficiency
• Bone density decrease
• c.diff

Question 16

esomperazole and omeprazole

Answer 16

don’t sue w/ clopidogrel

Question 17

H2RA and PPI formulation
OTC

Answer 17

• cimetidine
• famotidine
• ranitidine
• esomeprazole
• lansoprazole
• omeprazole

Question 18

H2RA and PPI formulation
ODT

Answer 18

• lansoprazole
• omeprazole

Question 19

Oral solutions/suspensions

Answer 19

• cimetidine
• famotidine
• nizatidine
• ranitdine
• lansoprazole
  packets for suspensions
• esomprazole
• omeprazole
• pantoprazole

Question 20

H2RA and PPI formulation
injection

Answer 20

famotidine
ranitidine

• esomprazole
• pantoprazole

Question 21

metoclopramide

Answer 21

reglan
- cytoprotective

Question 22

drugs that require acidic gut (decreased absorption by antacids, H2RAs and PPIs)

Answer 22

• antiretrovirals: rilpivirine (NNRTI), atazanavir (PI)
• antivirals: ledipasivr, velpatasvir/sofosbuvir
• azole: sporanox, ketoconazole, pasaconazole oral suspension
• cephalosporins (orals): cefpodoxime, cefuroxime
• iron products
• mesalamine
• risedronate delayed-released
• tyrosine kinase inhibitis: dasatanib, erlotinib, pazopanib

Question 23

oral drugs/drug classes that antacids bind to

Answer 23

• antiretrovirals: INSTIs- bictegravir, dolutegravir, elvitegravir, altegravir
• bisphosphonates
• isoniazid
• levothyroxine
• quinolones
• sotalol
• steriods
• tetracyclines

Question 24

bismuth quadruple therapy

Answer 24

10-14 days
bismuth subsalicylate 300mg QID
metronidazole 25-500mg QID
Tetracycline 500mg QID
PPI BID

Question 25

clarithromycin triple therapy

Answer 25

14 days
amox 1,000 mg BID
clarithro 500mg BID
PPI BID

Question 26

Prevpac

Answer 26

amox + clarithro+ lansoprazole

Question 27

sucralfate

Answer 27

carafate

Question 28

key drugs that are constipating

Answer 28

• antacid (Al and Ca based)
• Antidiarrheals
• clonidine
• colesevelam
  anticholinergic effect:
• antihistamines (diphenhydramine)
• antispasmodic (baclofen)
• phenothiazines (e.g. prochlorperazine)
• TCAs (e.g amitriptyline)
• urge incontinence drugs (e.g. oxybutynin)
• Iron
• non-DHP Ca channel blockers: especially verapamil!
• opioids
• sucrafate

Question 29

otc recommendations for constipation

Answer 29

Most adults: fiber
iron-induced or hard stool: docusate (stool softener)
opioids-induced: sena or bisacodyl (stimulants)
prego: fiber
Fast relief needed: adults: bisacodyl or glycerin (more gentle) suppository
Children: glycerin suppository

Question 30

psyllium

Answer 30

Metamucil
- Bulk-forming

Question 31

calcium polycarbophil

Answer 31

fiberCon
- Bulk-forming

Question 32

methylcellulose

Answer 32

citrucel
- Bulk-forming

Question 33

wheat dextrin

Answer 33

Benefiber
- Bulk-forming

Question 34

mag hydroxide

Answer 34

milk of magnesia
- osmotics

Question 35

polyethylene glycol

Answer 35

Miralax
- osmotics

Question 36

glycerine

Answer 36

• osmotics

Question 37

lactulose`

Answer 37

constulose, enulose,
- osmotics

Question 38

sodium phosphate

Answer 38

fleet enema
- osmotic

Question 39

bisacodyl

Answer 39

dulcolax

Question 40

lubiprostone

Answer 40

amitiza
-chloride channel activator

Question 41

linaclotide

Answer 41

linzess
- guanylate cyclase c agonists

Question 42

alvimopan

Answer 42

entereg
- PAMORAs

Question 43

naloxegol

Answer 43

Movantik
- PAMORAs

Question 44

methylnaltrexone

Answer 44

Relistor
- PAMORAs

Question 45

select drugs that cause diarrhea

Answer 45

• acetylcholinesterase inhibitors ( e.g. donepezil)
• antacids containing mag
• antibiotics (especially broad-spectrum drugs), diarrhea may be infections (e.g. C. difficile)
• antidiabetics (e.g. metformin, GLP-1 agonist)
• antineoplastic (e.g. irinotecan, capecitabine, fluorouracil, methotrexate, TKIs)
• Colchicine
• Drugs used for constipation (e.g. laxatives)
• Misoprostol
• Mycophenolate
• Prokinetics drugs (e.g. metoclopramide, cisapride)
• PI (especially nelfinavir)
• Quinidine
• Roflumilast

Question 46

bismuth subsalicylate

Answer 46

pepto-bismol

Question 47

loperamide

Answer 47

imodium

Question 48

diphenoxylate/atropine

Answer 48

lomotil

Question 49

dicyclomine

Answer 49

bentyl