GI Drugs (Upper And Lower) Flashcards
Antacids indications
hyperacidity caused by Heartburn, GERD, acid indigestion, sour stomach, peptic ulcer
Aluminum antacids side effects
Constipation , intestinal impaction, anorexia, weakness, tremors and bone pain
Calcium antacids side effects
Metabolic alkalosis, hypercalcemia, vomiting, confusion, headache, rebound hyperacidity, renal calculi, and neurological impairment
Sodium bicarbonate antacids side effects
systemic Alkalosis and rebound hyperacidity
Antacids considerations
Impair absorption of some other drugs
Histamine H2 antagonists ex
-tidine: cimetidine, famotidine, nizatidine, ranitidine,
Histamine H2 antagonists indications
Heartburn, acid indigestion, sour stomach, GERD, gastric or duodenal ulcer, gastric hypercecretory conditions, stress related ulcers, acute GI bleeding in critically ill patients,
Proton pump inhibitors indications
GERD, erosive esophagitis, prevent bleeding in patients using antiplatelet drugs, gastric and duodenal ulcers associated with h. pylori infections, pathologic hypersecretory conditions
Proton pump inhibitors considerations
Work better than H2 Agonists
Proton pump inhibitors ex
-prazole: omeprazole, lansoprazole, pantoprazole, rabeprazole, esomeprazole, dexlansoprazole,
Proton pump inhibitors administration
Take before eating
Sucralfate MOA
Pepsin inhibitor/mucosal protective drug
Sulfacrate indication
Used in the short term treatment of duodenal ulcers, preferred in pregnant women with GERD symptoms and for treatment of stress ulcers
Misoprostol indications
Decreases risk of NSAID induced gastric ulcer in high risk patients (elderly or critically ill)
Misoprostol consideration
Women MUST be on birth control
Antiemetic side effect
Drowsiness
Metoclopramide indication
Delayed gastric emptying and emesis
Metoclopramide MOA
Increases mobility of upper GI tract without increasing secretion production, and inhibits stimulation of the vomiting center in the brain
aminosalicylate interactions
reduced absorption of Digoxin, methotrexate increases risk of immunosuppression, hypoglycemics decrease blood glucose level, warfarin increases risk of bleeding
Olsalazine pregnancy cat
C
Diphenoxylate indications
Decrease peristalsis, and decrease lower GI motility, usually combined with atropine, and also used for diarrhea, and is chemically related to opioids
Diphenoxylate consideration
Can have sedative and euphoric effect, but it is NOT an analgesic, reduced abuse potential
Diphenoxylate interaction
Atropine
Loperamide MOA
Acts on wall of bowel to slow motility
Loperamide restriction
Not during pregnancy
Loperamide side effect
Dizzy/headache, sedation/euphoria, anorexia, constipation
Antidiarrheals restrictions
Not for people with bacterial diarrhea (e. Coli, salmonella, shigella) kids under 2, jaundice, pseudomembranous colitis, abdominal pain of unknown origin
Antidiarrheals precautions
Severe hepatic impairment, pregnancy (cat C),
Antidiarrheals interactions
Antihistamines
Antiflatulents ex
Simethicone, charcoal
Antiflatulents side effects
None
Charcoal uses
Prevention of nonspecific pruritud associated with kidney dialysis, and as an antidote in poisoning
Laxatives indication
Prevent occasional constipation
Lactulose indications
Hypersmotic agent, ammonia toxicity
Magnesium considerations
Caution with renal impairment
Aminosalicylates ex
Sulfasalazine (MUST maintain high fluid intake)
Aminosalicylates indications
Ulcerative colitis, crohn disease, and other inflammatory diseases
Aminosalicylates side effects
Abdominal pain, nausea, diarrhea, headache, dizziness, weakness, fever, and low sperm count
Aminosalicylates interactions
Cardiotonics, hypoglycemics, anticoagulants
Stimulant laxatives ex
Senna, or bisacodyl, cascara sagrada, sennosides, bisacodyl
Stimulant laxatives side effects
Brown urine, dark Colon mucosa
Docusate indications
Stool softener (relieve constipation)
Sucralfate indication
Protect coating for stomach lining
Gastric stasis
Failure of the body to remove stomach contents normally
Gastroesophageal reflux disease (GERD)
Reflux or backup of gastric acid contentos into the esophagus
Hydrochloric acid
Stomach acid that aids in digestion
Hypersecretory
Characterized by excessive secretion of a substance
Upper GI system includes
Mouth, esophagus and stomach
Proton pump inhibitors use
Treatment of helicobacter pylori infection in people with duodenal ulcers
Antacids MOA
Neutralize of reduce the acidity of the stomach and duodenal contents by increasing the pH of the stomach acid
Antacids ex
Aluminum, magaldrate, magnesium
Aluminum carbonate use
Hyperphosphatemia, or as an adjunct to a low phosphate diet to prevent formation of phosphate based urinary stones
Calcium use
Calcium deficiencies, such as menopausal osteoporosis
Magnesium uses
Magnesium deficiencies, magnesium depletion from malnutrition, restricted diet, or alcoholism
Magnesium antacids side effects
Severe diarrhea, dehydration, hypermagnesemia
Antacids contraindications
Severe abdominal pain of unknown cause, lactation
Sodium antacids contraindications
Cardiovascular problems, and people on sodium restricted diets
Calcium antacids contraindications
Renal calculi, hypercalcemia
Aluminum antacids precautions
Gastric outlet obstruction, or upper GI bleeding , decreased kidney function,
Antacids pregnancy cat
C, caution
Calcium antacids precautions
Respiratory insufficiency, renal impairment, cardiac disease
Magnesium antacids precautions
Decreased kidney function
Antacids interactions
Decreased absorption and decreased effect of digoxin, isoniazid, phenytoin, and chlorpromazine, decreased effectiveness of tetracycline, decrease anti inflammatory properties of corticosteroids, salicylates are excreted faster in the urine
Histamine H2 antagonists MOA
Inhibit the action of histamine at H2 receptor cells of the stomach, reducing the secretion of gastric acid, (selective only in stomach, so don’t cause the reactions of general body H2 receptors)
Histamine H2 antagonists side effects nature
Mild and very rare
Histamine H2 antagonists side effects
Dizziness, somnolence, headache, confusion, hallucinations, diarrhea, reversible impotence
Histamine H2 antagonists precautions
Renal or hepatic impairment, severely ill, elderly, debilitated patients, pregnancy (cat B), and lactation
Nizatidine pregnancy cat
C
Histamine H2 antagonists interactions
Antacids, and metoclopramide decrease absorption of H2 antagonists, carmustine decreases white blood cell count, opioid analgesics increase risk of respiratory depression, oral anticoagulants increase risk for bleeding, and increased serum digoxin levels
Proton pump inhibitors MOA
Suppress gastric acid secretions by inhibition of the hydrogen-potassium adenosine triphospatase (ATPase) enzyme system of the gastric parietal cells
Combination therapy for H. pylori in people with duodenal ulcers
One PPI + 2 anti-invectives, bismuth + 2 anti-invectives ,
Proton pump inhibitors side effects
Headache, nausea, diarrhea, abdominal pain
Proton pump inhibitors precautions
Elderly, hepatic impairment, prolonged treatment can reduce ability to absorb vitamin B12, causing anemia
Proton pump inhibitors contraindications
Pregnancy (cat B), lactation
Omeprazole pregnancy cat
C
Proton pump inhibitors menopausal women considerations
Increase in features in hip, wrist, and spine in people taking high PPI doses and undergoing osteoporosis treatment with biophosphonates