GI Drugs Flashcards
Docusate/ colace
Stool softener Constipation, hemorrhoids, prophylaxis for pts who should not strain Anionic surfactant May cause: Gas, bloating or cramping PO- caps or liquid, PR suppository 1-3 day onset
Psyllium/ Metamucil
Fiber laxative
Constipation, irritable bowel, reduction of colon cancer risk, reduction of cholesterol levels
Soluble & insoluble fiber
PO- powder, caps, wafers
Magnesium hydroxide/ milk of magnesia
Hydrating/ osmotic laxative
Mg salts are poorly absorbed- act as osmotic agent to draw water into lumen
Electrolyte imbalances are greater risk in pts with renal dz
PO- chew tabs, caps, liquid
6hrs for onset
Biscodyl/ dulcolax
Stimulant laxative
Inc. intestinal motility
SE: diarrhea, abd. Cramping, sweating, possible laxative dependence
PO- 2-6 hrs for onset
Loperamide/ Imodium
Anti-diarrheal analog of meperidine
For acute diarrhea, management of chronic diarrhea in pts with IBD
Diminished peristalsis via activation of opiate receptors in GI- works on myenteric plexus not CNS.
SE: dizziness, HA
For all laxatives:
Do not use if obstruction suspected, always work from the bottom up!
For all anti-diarrheal meds:
Do not use if bacterial or parasitic infx suspected- fever present
Do not use in severe cases of colitis- may cause toxic mega colon
Diphenoxylate with atropine/ lomotil
Anti diarrheal- for acute diarrhea
Causes decreased peristalsis because:
Diphenoxylate is a morphine analog
Atropine is and ACH inhibitor
SE: dry mouth, urinary retention, BPH in men
Take no longer than 48hrs w/o consulting physician
Bismuth subsalicylate- pepto-bismol
Anti-microbial, anti-inflammatory
May cause black tongue & stool
Other anti diarrheal meds
Kaolin & pectin- kaopectate
Opiates & synthetic opiates
Meclizine/ antivert
Anti- emetic, sedating antihistamine
H1 histamine blocker
For mild to moderate nausea
Metoclopramide/ reglan
Antiemetic, pro-kinetic
Increases peristalsis in jejunum & duodenum, inc. gastric tone & amplification of contractions
Mild-moderate nausea, gastric stasis- gastric surgery, DM, GERD
CI in parkinsons pts - may worsen sxs!
Ondansetron/ zofran
Antiemetic
Severe nausea
Block serotonin receptor sites(5HT3)
IV given as adjuvunct care to chemo tx- prophylaxis
Corticosteroids
Unknown MOA
for chemo induced nausea
Marijuana
Marinol
Mild-moderate nausea
Syrup of ipecac
Emetic- induces vomiting
Stimulation of medullary chemoreceptor trigger zones
Local irritant to GI tract
SE: abd mm spasm, dizziness, dehydration
PO- onset of eyes is in 10-30 min- give with large amounts of water
Triple therapy for PUD
PPI + 2 abx- blocks acid secretion for mucosal healing
Bismuth subsalicylate + 2 abx- damages H. pylori cell wall, reduces adherence to mucosa
Abx options: amoxicillin, erythromycin, clairithromycin, tetracycline, metronidazole
Dosing for triple therapy PUD
Omeprazole (Prilosec) 20mg BID
Amoxicillin (Amoxil) 1gm BID
Clarithromycin (Biaxin) 500mg QD
-OR-
Metronidazole (Flagyl) 500mg QDCalcium carbonate/ tums
Relief of gastric acid irritation
Neutralizes stomach acid, reduces inflammation of stomach lining
May cause constipation
May disrupt the absorption of nutrients due to change in stomach pH
Ranitidine/ Zantac
H2 histamine receptor antagonist
Gastritis, PUD, GERD
Blocks histamines on parietal cells- dec acid production
Omeprazole/ Prilosec
PPI Gastritis, GERD, PUD Inhibits H/K pumps of parietal cells= dec acid secretion HA, dizziness, diarrhea 2-8 wks for GERD 1-2 wks for PUD OTC- 5mg Rx- 10, 20, 40mg
Esomerazole/ nexium
PPI
Enantiomer of Prilosec
5-ASA/ mesalamine
Aminosalicylate- pro drug- absorbed in SI
For IBD
Inhibition of leukotriene production
Anti-prostaglandin & anti-oxidant effects
N/V, diarrhea, abd. Pain, possible nephrotoxicity
PO, IM, IV
PR suppository for distal UC
Metronidazole/ flagyl
Ciprofloxacin/ ciprofloxin
Antibiotics for crohn’s
