GI Drugs Flashcards
Famotidine/Cimetidine
Short term
treatment of
duodenal ulcer or
benign gastric
ulcer.
Prophylaxis of
stress induced
ulcer and acute
upper GI bleeding.
Erosive
gastroesophageal
reflux.
Relieve symptoms
of heartburn, acid
indigestion and
sour stomach
Famotidine:
Treatment of
pathological hyper
secretory condition
(Zolliger-Ellison
syndrome).
Adverse: diarrhea,
constipation
dizziness,
headache
Somnolence,
Hallucination,
confusion
arrhythmias
hypotension
Prolonged use:
gynecomastia and
impotence
Cimetidine:
Antiandrogenic
effects
(gynecomastia /
galactorrhea)
Administer drug with
or before meals.
Effectiveness of H2
blocker ↓ if given
same time as antacid.
Route: Oral, IV, IM-
Monitor continually if
given IV.
Need compliance with
therapy to achieve
needed results.
Caution:
pregnancy/lactation,
hepatic or renal
dysfunction.Famotidine – approved
for children ages 1-16
Sodium
bicarbonate/Calcium
carbonate
Symptomatic relief
of upset stomach
associated
hyperacidity and
hyperacidity
associated with
peptic ulcer,
gastritis, peptic
esophagitis, gastric
and hiatal ulcer
Adverse: Acid rebound
due to frequent
administration of
antacid;
constipation
Acid base and
electrolyte
imbalance
Oral: Administer drug
apart from any other
oral medication 1hr
before or 2hrs after
meals- delays
absorption of other
drugs
Take with 2-4 oz water.
Do not take with milk.
Chew tablet
Omeprazole/
Pantoprazole/
Esomeprazole
Relief of heartburn
Treatment of:
gastric ulcer, GERD,
Pathological hyper
secretory
syndrome
maintenance
therapy for healing
duodenal ulcer and
esophagitis.
All: In combination
therapy for
eradication of H.
pylori infection.
Esomeprazole
highest success
rate for treating
erosive GERD
Adverse: dizziness,
headache, Asthenia
(loss of strength),
dream abnormality
Dry mouth,
tongue atrophy,
N/V, Abdominal
pain.
URI
hoarseness,
epistaxis.
Rash,
alopecia, pruritus,
dry skin
Recent studies:
bone loss, ↓
calcium levels, ↓
Mg levels, and
↑incidence of
Clostridium difficile
diarrhea and
pneumonia
Oral for 4-8weeks
based on condition and
response.
Safety of these drugs
have not been
established for children
less than 18yrs.
All can ↑ Dig, oral
anticoagulants,
phenytoin levels.
Administer drug before
meals
Do NOT open, chew or
crush capsule. Swallow
whole.
Arrange for medical
follow up if symptoms
not resolved after 4 to
8weeks of therapy. It
may be a serious
underlying condition.
May ↓antiplatelet
effects of clopidogrel
sucralfate
Short term tx of
duodenal ulcer,
Tx oral and
esophageal ulcer
due to radiation,
chemotherapy or
sclerotherapy
Being studied for
treatment of NSAID
induced gastric
ulcer, gastric
damage
Adverse: Constipation
most frequently
seen adverse
effect.
Diarrhea, dry
mouth, nausea,
gastric discomfort
GI Protectant
Pancrelipase
Replacement
therapy in patient
with exocrine
pancreatic
secretion desire
improved
nutritional status.
Normalization of
stools in pts. With
steatorrhea
Adverse: N/V,
Abdominal cramps,
diarrhea
Give Immediately
before or with food
and snacks
Do not crush or chew
capsule, MUST be
swallowed whole
MAY be sprinkled on
food or taken without
chewing
Generally, not
absorbed
systematically
Caution: heart failure,
HTN, Renal failure;
Allergy to pork product
Sit upright and drink
fluids to enhance
swallowing
Antacids may ↓
effectiveness
Bisacodyl/
Senna
Pre-procedure
(surgery or
diagnostic tests)
emptying of GI
tract.
Prevention of
constipation and
straining after GI
surgery, MI,
obstetrical
delivery
Short term
treatment of
constipation
Adverse: diarrhea,
abdominal
cramping, nausea
dizziness,
headache,
weakness
Sweating,
palpitations,
flushing, and
fainting
Cathartic
Dependence
Separate taking ALL
laxatives and other
medications by at
least 30 minutes.
Administer oral forms
with a full glass of
water and caution the
patient not to chew
tablets to ensure
therapeutic effects
May be given in
combinations
Magnesium
Citrate/
Psyllium
Mg. Citrate
Preprocedure;
Prevention of
constipation
Psyllium:
Short term relief
of occasional
constipation
Adverse: diarrhea,
abdominal
cramping, nausea
Dizziness
Directly effective in GI
tract → not generally
absorbed systemically
May impact
absorption due to ↑
motility of GI tract
Docusate
Given when stool
softener needed;
prevent
constipation
Adverse: cramps,
diarrhea, bloating,
perianal irritation;
leakage of stool
and staining
dizziness
Docusate May take 1-
5 days for effect
Interferes with
absorption of fat-
soluble vitamins
A,D,E, & K
Lactulose
Chronic
constipation
Adjunct therapy
for portal-
systemic
encephalopathy
(PSE) end stage
liver problems
Adverse: belching,
cramps,
distention,
flatulence,
diarrhea
hyperglycemia (in
DM patients)
Give with full glass
(240 ml) of water or
juice
Monitor
serum electrolytes
In PSE assess mental
status (orientation,
LOC) before and
during therapy –
should see improvement in 24-48
hrs.
Metoclopramide
Acute and chronic
diabetic
gastroparesis
Short term
treatment of
gastro esophageal
reflux disorder
(GERD)
Prevention of
postop or chemo
induced N&V;
facilitation of
small bowel
intubation;
stimulate gastric
emptying;
elimination of
barium
Adverse: Restlessness,
drowsiness,
fatigue,
extrapyramidal
effects,
Parkinson-like
reactions,
diarrhea
PO, IM, IV
Administer at least 15
minutes before each
meal and at bedtime
↓absorption with Dig
↓immunosuppressive
effects and increased
toxicity of
cyclosporine
Loperamide
Control and
symptomatic
relief of acute
diarrhea and
chronic diarrhea
associated with
irritable bowel
syndrome (IBS)
↓volume of
discharge from
ileostomies
Adverse: dizziness;
tiredness;
drowsiness
Abdominal
pain, distention,
or discomfort, dry
mouth; nausea;
constipation;
Administer the drug
after each unformed
stool
If no response is seen
within 48 hours the
diarrhea could be
related to an
underlying medical
condition
Drug / drug
interactions with CNS
depressants, ETOH,
or anticholinergics
prochlorperazine
Severe nausea
and vomiting
associated with
anesthesia
Adverse: Drowsiness,
dystonia
photophobia,
blurred vision
urine discolored
pink to red-brown
Photosensitivity.
Drug of choice with
children.
Contraindicated in
coma or severe CNS
depression, severe
hypotension or
hypertension
Wear sunscreen and
protective clothing
Promethazine
Prevention and
control of nausea
and vomiting
associated with
anesthesia and
surgery
Adverse: Drowsiness,
dizziness,
weakness,
tremor, headache
hypotension,
hypertension,
arrhythmias
Urine
tinged pink to
red-brown
Photosensitivity
Contraindicated in
patients with coma or
severe CNS
depression, brain
injury/damage,
severe hypotension or
severe liver
dysfunction.
Wear sunscreen and
protective clothing
Meclizine
Prevention and
treatment of
nausea and
vomiting,
motion sickness,
vestibular
problems
Adverse: Drowsiness,
confusion
dry mouth,
anorexia
Renal: urinary
frequency.
Oral drug
Caution in narrow-
angle glaucoma,
benign prostatic
hyperplasia, peptic
ulcer disease (PUD),
bronchial asthma,
hypotension
↑sedation with
alcohol
Ondansetron
Control of severe
nausea and
vomiting
associated with
emetogenic
cancer
chemotherapy,
radiation therapy;
treatment of
postoperative
nausea and
vomiting.
Adverse:
Headache,
dizziness,
drowsiness
prolongs QT
interval
Renal: urinary
retention
constipation,
↑ liver enzymes
Local: pain at
injection site
Serotonin
syndrome
Extrapyramidal
reactions
PO and IV routes
Many Drug / drug
interactions
Assess CNS / Neuro,
and cardiac
