GI Drugs Flashcards by Samantha Sanders

brand name for pantoprazole

protonix

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generic name for Prilosec

omeprazole

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major indications for proton pump inhibitors (PPI)

gastroesophageal reflux disease (GERD) and peptic ulcer disease

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MOA for PPI

irreversible blocking the gastric proton pump of the gastric parietal cells

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common adverse drug reactions for PPI

hypocalcemia, B12 defiency, and rebound

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rare adverse drug reactions for PPI

bone fracture, interstitial nephritis and infections

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counsel points for PPI

administer 30 minutes before a meal, ideally breakfast

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histamine type 2 receptor antagonists (H2RA) generic name

famotidine

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histamine type 2 receptor antagonists (H2RA) brand name

pepcid

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major indications for H2RA

GERD

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MOA for H2RA

block histamine at H2 receptor on the parietal cell

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black box warnings for H2RA

ranitidine (zantac) removed from market d/t NDMA levels

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common ADRs for H2RA

b12 defiency and tachyphylaxis

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rare ADRs for H2RA

CNS effects

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counseling points for H2RA

good for occassional heartburn b/c works quicker than PPI, don’t need to take on empty stomach before a meal

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mucosal protectant generic name

sucralfate

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mucosal protectant brand name

carafate

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major indications for mucosal protectant

GERD and peptic ulcer disease

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MOA for mucosal protectant

Forms a complex by binding with positively charged proteins in exudates, forming a viscous
paste-like, adhesive substance. This selectively forms a protective coating that acts locally to
protect the gastric lining against peptic acid, pepsin, and bile salts

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counseling point for mucosal protectant

may block absorption of some medications

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generic name for phenergan

promethazine

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brand name for prochlorperazine

compazine

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brand name for metoclopramide

reglan

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generic name for zofran

ondansetron

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major indication for antiemetics | promethazine, prochlorperazine, metoclopramide and ondansetron

nausea and vomiting

MOA for promethazine and prochlorperazine | phenergan and compazine

inhibit dopaminergic, histaminic and muscarinic activity in the CTZ (chemoreceptor trigger zone)

MOA for metoclopramide | reglan

dopamine antagonist, enhances response to acetylcholine in upper GI tract and blocks signals to CTZ that trigger vomiting

MOA for ondansetron | zofran

5-HT3-receptor antagonist which blocks serotonin, both in gut and centrally in the CTZ

major contraindication for promethazine

* children under 2 * compromised respiratory function

major contraindication for prochlorperazine

* children under 2 * presence of CNS depressants

major contraindications for metoclopramide (reglan)

history of dystonic reaction to metoclopramide administration

major contraindication for ondansetron

high IV doses should be avoided in congenital long QT syndrome | long QT: longer than usual for the heart to recharge between beats

black box warnings for promethazine

* respiratory depression: kids under 2 * severe tissue injury (IV and SC use not recommended)

black box warnings for prochlorperazine

elderly patients with dementia: increase risk of death with antipsychotics

black box warnings for metoclopramide

tardive dyskinesia (EPS) | repetitive, involuntary movements, such as grimacing and eye blinking.

common ADRs for promethazine and prochlorperazine

* CNS: drowsiness, dizziness, delirium * anticholinergic effects * orthostatic hypotension

common ADRs for metoclopramide

* CNS: drowsiness, fatigue, dizziness, confusion * diarrhea

common ADRs for ondansetron

* constipation * CNS: headache, fatigue

rare ADRs for promethazine

* respiratory depression * tissue damage * EPS * QTc prolongation

rare ADRs for prochlorperazine

* EPS * QTc prolongation

rare ADRs for metoclopramide

QTc prolongation

rare ADRs for ondansetron

QTc prolongation

key counseling points for promethazine

beers and KIDS list

key counseling points for prochlorperazine

* beers and KIDS list * available as suppository

key counseling points for metoclopramide

* beers and KIDS list * avoid long term use when possible

brand name for antidiarrheal agent

lomotil

generic name for antidiarrheal

diphenoxylate/atropine

major indication for lomotil

diarrhea

MOA for anti-diarrheal

* opiate derivative - works on μ and δ receptors in the gut * atropine solely to reduce abuse potential

major contraindications for lomotil

* C. diff * kids under 6

common ADRs for anti-diarrheal

CNS depression

rare ADRs for anti-diarrheal

atropinism (anticholinergic) | poisoning by atropine

key counseling points for anti-diarrheal

beers and KIDS list

generic name for constipation agent

polyethylene glycol

brand name for constipation agent

* miralax * golytely

major indication | polyethylene glycol

* constipation - occasional and chronic idiopathic * bowel prep before colonoscopy

MOA for constipation agent

osmotic agent: pulls water into stool

major contraindications for constipation agent

use only under the direction of a health care provider if kidney disease is present (OTC)

common ADRs for constipation agent

abdominal cramping, distension, pain, bloating, diarrhea, flatulence

key counseling points for constipation agent

dissolve a capful in at least 4 ounces of fluid

brand name for dicyclomine

bentyl

generic name for linzess

linaclotide

brand name for lubiprostone

amitiza

generic name for xifaxan

rifaximin

major indications for bentyl

IBS - associated abdominal pain

major indications for linzess and amitiza

* IBS-Constipation * opiod induced constipation * chronic idiopathic constipation

major indications for xifaxan

* IBS * hepatic encephalopathy | loss of brain func occurs when a liver doesn't remove toxins from blood.

MOA for bentyl

anticholinergic - blocks acetylcholine at muscarinic receptors in smooth muscle

MOA for linzess

Agonizes guanylate cyclase-C on the luminal surface of intestinal epithelium. Intracellular and extracellular cGMP concentrations are subsequently increased resulting in chloride and bicarbonate secretion into the intestinal lumen. Intestinal fluid increases and GI transit is accelerated

MOA for amitiza

Cl- channel activator – increases intestinal fluid and improves fecal transit

MOA for xifaxan

inhibits bacterial RNA synthesis by binding to bacterial DNA-dependent RNA polymerase

major contraindications for bentyl

glaucoma

major contraindication for linzess

* kids under 2 * GI obstruction

major contraindication for amitiza

GI obstruction

black box warning | linzess

serious dehydration in kids under 2

common ADRs for bentyl

* nausea * anticholinergic - dizziness, blurred vision, dry mouth

common ADRs for linzess

diarrhea

common ADRs for amitiza

* nausea * diarrhea

rare ADRs for xifaxan

increased risk of resistant infections

key counseling for bentyl

anticholinergic side effecting counseling

key counseling points for xifaxan

use should be limited to 14 days for IBS