GI Disease Medications Flashcards
What is the purpose of antacids?
provide rapid relief of heartburn & are adjunctive or for occasional GERD
avoid Mg-containing in renal failure
What are the names of the antacids mentioned?
tums, rolaids, maalox, gaviscon
What is the purpose of H2 receptor antagonists?
mild esophagitis in GERD (heals 70-80%) & is effective for symptomatic gastritis
What is the MOA of H2 receptor antagonists?
Blocks the effect of histamine on gastric cells –>
- decreased acid production
- eliminates ACh & gastrin on acid production
What is the brand name of Famotidine & what class is it in?
H2 blocker: Pepcid
What is the brand name of Ranatadine & what class is it in?
H2 blocker: Zantac
What is the brand name of Cimetidine & what class is it in?
H2 blocker: Tagamet
What effect do H2 blockers have in CKD & pregnancy?
Dose adjusted in CKD & not used in ESRD
Safe in pregnancy & lactation
What are the 2 main side effects of H2 blockers?
Tachyphylaxis
B-12 deficiency
HoTN, QT prolongation (with rapid infusion)
confusion/hallucinations (in elderly)
What is the purpose of PPIs?
most powerful tx for GERD
What is the MOA of PPIs?
binds to H/K ATPase pump in gastric parietal cells –> acid secretion blockage (take in AM- need acid to work)
What is the brand name of Omeprazole and what class is it in?
PPI: Prolisec
What is the brand name of Lansoprazole & what is the class?
PPI: Prevacid
What is the brand name of Dexlansoprazole & what is the class?
PPI: Dexilant
What is the brand name of Rabeprazole & what is the class?
PPI: Aciphex
What is the brand name of Pantoprazole & what is the class?
PPI: Protonix
What is the brand name (2) of Esomeprazole/Na Bicarb & what is the class?
PPI: Nexium/Zegerid
What is the effect of PPIs in CKD & pregnancy?
Increased risk of CKD (but no need to dose adjust)
Safe in pregnancy
What is the brand name of Carafate?
Sulcrafate
What is the MOA of Carafate?
ulcer-adherent & protects the ulcer; stimulates gastric angiogenesis & formation of granulation tissue
What is the use of Carafate?
MC as an add-on tx for patients not well enough controlled on H2 blockers or PPIs
What is the brand name (2) of Bismuth?
Peptobismol, Kaopectate
What is the MOA of Bismuth?
Suppresses H. pylori, binds to ulcer & promotes healing
What is the brand name of Misoprostol?
Cytotec
What is the MOA of Misoprostol?
analogue of prostaglandin E which inhibits acid secretion & enhances mucosal defense
What is the indication for Misoprostol?
used only to prevent NSAID induced gastritis
What is the effect of Misoprostol on pregnancy?
contraindicated in women of childbearing age not on contraception
What is the algorithm for GERD/PUD/Gastritis?
H2 or PPI (can’t use antacids routinely w/PPIs) & continue tx for 4-8w
If no improvement, increase PPI to bid or add adjunctive tx
If no improvement, endoscopy
If refectory, Nissen fundoplication (for GERD)
What is the treatment of PUD/Gastritis?
eradicate H. pylori, PPI or H2 for 4w for duodenal ulcer, & 8w for gastric ulcer
- avoid NSAIDs, if pt must, give PPI or Misoprostol (Cytotec)
What is the brand name of Ondansetron and what class is it in?
SSRAs (5-H3T Receptor Antagonists): Zofran
prn (not a scheduled med)
What is the indication of SSRAs/5H3T?
most useful class in chemo & postop n/v
What is the important AE of SSRAs/5H3T?
QT prolongation, torsades
What is the brand name of Aprepitant and what is the class?
Neurokinin Receptor Anatagonist: Emend
Fosaprepitant [IV]
What is the indication of Aprepitant?
prevention of chemo emesis
What is the brand name of Diphenyldramine & what class is it in?
Antihistamine: Benadryl
What is the brand name of Hydroxyzine & what is the class?
Antihistamine: Vistaril
What is the brand name of Promethazine & what is the class?
Antihistamine: Phenagran
What are the AEs of Benadryl?
CNS depression, sedation, anticholinergic SEs, exraparamidal
What are the AEs of Vistaril?
involuntary movement, respiratory depression, anticholinergics
What is are the AEs of Phenegran?
anticholinergics, sedation, extrapyramidal symptoms, NMS, tissue injury
What is the brand name of Scopolamine & what class is it in?
Transderm Scop (patch)
What is the indication of Scopolamine?
MC for motion sickness
Adjunct chemo N or prolonged mild N
What are the AEs of Scopolamine?
in old: confusion & anticholinergic effects
What is the brand name of Prochlorperazine and what class is it in?
Dopamine Receptor Antagonist: Compazine
What is the brand name of Chlopromazine and what class is it in?
Dopamine Receptor Antagonist- Phenothiazines: Thorazine
What are the SEs of Dopamine Receptor Antagonists?
QT prolongation, potentiation of CNS depressants
What is the brand name of Metoclopramide and what class is it in?
Dopamine Receptor Antagonist- Benzamides: Reglan
What is the brand name of Dronaninol & what class is it in?
Cannaboid: Marinol
What are the SEs of Marinol?
hallucinations, paranoia, euphoria, sedation, “highs”
What is the indication of Marinol?
chemo n/v when other agents aren’t effective
What are the indications of glucocorticoids?
chemo-induced
