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GI drugs Flashcards

1
Q

Tums

A

Antacid
Calcium carbonate

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2
Q

Mylanta supreme

A

Antacid
Calcium carbonate + magnesium
Not recommended if CrCl < 30

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3
Q

Maalox Advanced Maximum Strength

A

Antacid
Calcium carbonate + simethicone

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4
Q

Milk of Magnesia

A

Antacid, Osmotic Laxative
Magnesium hydroxide
Not recommended if CrCl < 30

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5
Q

Mylanta Maximum Strength

A

Antacid
Magnesium hydroxide + aluminum + simethicone
Not recommended if CrCl < 30

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6
Q

Alka-Seltzer

A

Antacid
Sodium bicarbonate / Aspirin / Citric acid

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7
Q

Calcium ADE

A

Constipation
Bloating
Belching

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8
Q

Aluminum ADE

A

Constipation
Hypophosphatemia

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9
Q

Magnesium ADE

A

Loose stools

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10
Q

Zantac

A

H2RA
Ranitidine

Unique ADE:
- increased ALT

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11
Q

Pepcid

A

H2RA
Famotidine

Unique ADE:
- QT prolongation with renal dysfunction

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12
Q

H2RAs Class Attributes

A

Onset: within 1 hour
Duration: 4-10 hours
Warnings:
- Confusion
- B12 deficiency with chronic use
ADE:
- generally well tolerated
- CNS effects
Reduce dose at CrCl < 50
Take PRN for acute treatment
Take 60 min before meal for prophylaxis

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13
Q

Dexilant

A

PPI
Dexlansoprazole
take without regard to meals

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14
Q

Nexium

A

PPI
Esomeprazole

IV formulation available

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15
Q

Prevacid

A

PPI
Lansoprazole

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16
Q

Prilosec

A

PPI
Omeprazole

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17
Q

Protonix

A

PPI
Pantoprazole
Admin:
- tablet -> w/o regard to meals
- suspension -> 30 min before meal

IV formulation available
- ADE: thrombophlebitis, SJS/TENs risk

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18
Q

PPI Class Attributes

A

Onset: 1-2 hrs
Duration: > 24 hrs
ADE (mild & infrequent):
- HA
- Nausea
- Dizziness
Admin:
- take 30-60 min before breakfast (& dinner if BID)

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19
Q

Drugs that worsen GERD

A

Aspirin/NSAIDs
Bisphosphonates
Estrogen products
NRT
Steroids
Tetracyclines
Fish oil
Iron supplements

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20
Q

DDI: Acid suppressing agents decrease the absorption of…

A

Antiretrovirals
Antivirals
Azole antifungals
Cephalosporins
Iron products
Mesalamine
Risperidone
TKIs

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21
Q

DDI: antacids bind…

A

antiretrovirals
bisphosphonates
isoniazid
mycophenolate
quinolones
sotalol
steroids (esp budesonide)
tetracyclines
thyroid products

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22
Q

Miralax

A

PEG 3350
Osmotic laxative

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23
Q

FiberCon

A

Calcium Polycarbophil
Bulk-forming laxative

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24
Q

Metamucil

A

Psyllium
bulk- forming laxative

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25
Citrucel
Methylcellulose Bulk-forming laxative
26
Colace
Docusate Stool softener
27
Ex-Lax, Senakot
Senna Stimulant laxative
28
Dulcolax
Bisacodyl Stimulant laxative
29
Bentyl
Dicyclomine Anticholinergic agent used for cramps Warnings: - anticholinergic -> Beer's list - caution in UC (risk of toxic megacolon or paralytic ileus)
30
Amitiza
Lubiprostone Chloride channel activator Use: IBS-C, CIC, OIC ADE: nausea DDI: - methadone decreases effects of lubiprostone -> consider alternate OIC agent
31
Linzess
Linaclotide Use: IBS-C, CIC Boxed warning: can cause severe dehydration in pediatric patients -> do not use ADE: diarrhea Admin: swallow whole or mix capsule contents with applesauce or room temp water (swallow immediately)
32
Trulance
Plecanatide FDA approved for IBS-C
33
Pepto-Bismol
Bismuth subsalicylate Anti-diarrheal Boxed warnings: - salicylate allergy - taking other salicylates - GI ulcer or bleeding Warning: children and teenagers recovering from viral infections should not use due to Reye's syndrome ADE: - Black tongue/stool - salicylate toxicity (tinnitus) - nausea
34
Imodium
Loperamide Anti-diarrheal Boxed warnings: - cardiac arrest & sudden death with higher than recommended doses - do not use in children < 2y CI: - acute dysentery (bloody diarrhea + fever) - pseudomembranous colitis - bacterial enterocolitis ADE: constipation Notes: - do not use > 48 hrs - can be abused for mild opioid-like high in large doses
35
Xyfaxan
Rifaximin Use: IBS-D costly high risk of relapse
36
Lotronex
Alosetron Class: 5HT-3 RA Use: IBS-D approved for women only use restricted due to risk of ischemic colitis
37
Lomotil
Diphenoxylate / Atropine Antidiarrheal CI: - do not use liquid in children < 2y or tablets in children < 6y d/t risk of severe CNS depression - C diff associated diarrhea ADE: - diphenoxylate -> euphoria - atropine -> anticholinergic effects Notes: - liquid formulation is recommended for patients 2-13 yrs
38
Rayos
Prednisone Systemic steroid
39
Entocort
Budesonide Systemic steroid CD
40
Uceris
Budesonide Systemic steroid UC
41
Azasan, Imuran
Azathioprine Class: Thiopurine
42
Purixan
Mercaptopurine Class: Thiopurine
43
Asacol
Mesalamine, 5-ASA Aminosalicylate PO formulation
44
Canasa
Mesalamine, 5-ASA Aminosalicylate Suppository for distal UC only
45
Rowasa
Mesalamine, 5-ASA Aminosalicylate Enema for distal UC only
46
Cimiza
Certolizumab Anti-TNF CD only
47
Simponi
Golimumab Anti-TNF UC only
48
Humira
Adalimumab anti-TNF CD & UC
49
Remicade, Inflectra, Renflexis
Infliximab anti-TNF CD & UC
50
Stelara
Ustekinumab interleukin inhibitor CD
51
Xeljanz
Tofacitinib Janice kinase inhibitor UC
52
Trexall
Methotrexate Antineoplastic, Antifolate CD
53
Gengraf, Neoral, SandIMMUNE
Cyclosporine Calcineurin inhibitor UC
54
Entyvio
Vedolizumab Integrin receptor agonist CD & UC
55
Tysabri
Natalizumab Integrin receptor agonist CD
56
Benadryl
Diphenhydramine Antihistamine
57
Bonine
Meclizine Antihistamine
58
Dramamine
Dimenhydrinate Antihistamine
59
Marizine, Marzine, Emoquil
Cyclizine Antihistamine
60
Transderm Scop
Scopolamine patch anticholinergic agent Use: motion sickness, nausea caused by surgery
61
Entereg
Alvimopan Class: peripherally acting mu-opioid receptor antagonist Use: reduce risk of post-op ileus Boxed warning: risk of MI with long-term use (maximum duration 15 days, REMS) Contraindication: > 7 consecutive days of opioid use immediately prior to use
62
Relistor
Methylnaltrexone Class: PAMORA Use: OIC
63
Movantik
Naloxegol Class: PAMORA Use: OIC
64
Drugs that cause constipation
Antacids (Al & Ca containing) Antidiarrheals Clonidine Colesevelam Anticholinergics Iron Opioids Sucralfate
65
Drugs that cause diarrhea
Acetylcholinesterase inhibitors (eg donepezil) Antacids (Mg containing) Antibiotics Antidiabetics Antineoplastics Colchicine Laxatives Misoprostol Mycophenolate Prokinetic drugs (metoclopramide, cisapride) Protease inhibitors (esp nelfinavir) Quinidine Roflumilast
66
Side effects of long term PPI use
C diff Osteoporosis-related fractures Hypomagnesemia Vitamin B12 deficiency
67
Pylera
Bismuth subsalicylate + Metronidazole + Tetracycline Used with BID PPI for H. pylori PUD Admin: QID CI: - alcohol use (do not use metronidazole) - pregnancy or children < 8y (do not use tetracycline)
68
Steroid ADE
ADE: - short term -> inc appetite/weight gain, mood swings, insomnia - long term -> adrenal suppression/Cushing's syndrome, osteoporosis Notes: - if used for > 2 weeks, must taper

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