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

GI Flashcards by Krupa Bhakta

Key drugs that can worsen GERD symptoms

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

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calcium carbonate

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

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magnesium hydroxide

milk of magnesia
- antacids

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sodium carbonate/aspirin/citric acid

alka-seltzer
- antacids

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antacid notes:

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

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famotidine

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

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ranitidine

Zantac
all produced removed april 2020
- H2RA

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cimetidine

tagamet
high dose: gynecomastia, impotence
- H2RA

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antacid >2 years

vitamin b12 deficiency

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esomeprazole

nexium
- PPI

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lansoprazole

Prevacid
- PPI

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omeprazole

Prilosec
- PPI

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dexlansoprazole

Dexilant
- PPI

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pantoprazole

Protonix
- PPI

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PPIs

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

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esomperazole and omeprazole

don’t sue w/ clopidogrel

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H2RA and PPI formulation
OTC

cimetidine
famotidine
ranitidine
esomeprazole
lansoprazole
omeprazole

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H2RA and PPI formulation
ODT

lansoprazole
omeprazole

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Oral solutions/suspensions

cimetidine
famotidine
nizatidine
ranitdine
lansoprazole
packets for suspensions
esomprazole
omeprazole
pantoprazole

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H2RA and PPI formulation
injection

famotidine
ranitidine

esomprazole
pantoprazole

metoclopramide

reglan
- cytoprotective

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

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

oral drugs/drug classes that antacids bind to

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

bismuth quadruple therapy

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

clarithromycin triple therapy

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

Prevpac

amox + clarithro+ lansoprazole

sucralfate

carafate

key drugs that are constipating

- 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

otc recommendations for constipation

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

psyllium

Metamucil - Bulk-forming

calcium polycarbophil

fiberCon - Bulk-forming

methylcellulose

citrucel - Bulk-forming

wheat dextrin

Benefiber - Bulk-forming

mag hydroxide

milk of magnesia - osmotics

polyethylene glycol

Miralax - osmotics

glycerine

- osmotics

lactulose`

constulose, enulose, - osmotics

sodium phosphate

fleet enema - osmotic

bisacodyl

dulcolax

lubiprostone

amitiza -chloride channel activator

linaclotide

linzess - guanylate cyclase c agonists

alvimopan

entereg - PAMORAs

naloxegol

Movantik - PAMORAs

methylnaltrexone

Relistor - PAMORAs

select drugs that cause diarrhea

- 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

bismuth subsalicylate

pepto-bismol

loperamide

imodium

diphenoxylate/atropine

lomotil

dicyclomine

bentyl