GI Medications Flashcards
Antacids
calcium carbonate (Tums)
Use = acid reflux
MOA = neutralize gastric acidity
Increases stomach pH from 1.3 - 3.5
AE = DDI, avoid taking within 2 hours of oral meds.
H2 Receptor Antagonists
(“-tidine”)
Use = acid reflux and heals ulcers
famotidine (Pepsid)
ranitidine (Zantac)
MOA = reduce secretion of stimulated acid
Take before bed
AE = usually well tolerated; diarrhea, muscle pain, rashes
Proton Pump Inhibitor
(“-prazole”)
Use = acid reflux and heals ulcers (more effective than H2 receptor antagonist)
omeprazole (Prilosec)
esomeprazole (Nexium)
MOA = irreversibly inhibits H+/K+ ATPase pump in parietal cell membrane which blocks final step in acid secretion into lumen of stomach.
AE = long term use is associated with gastric polyps, altered calcium metabolism , some cardiovascular abnormalities
Must be taken with food.
Anticholinergics
scopolamine (Transderm Scop)
patch
Use = prevent motion-sickness related to vomiting
MOA = binds Ach receptors on vestibular nuclei, blocks communication.
AE = dizziness, drowsiness, dry mouth, blurred vision, dilated pupils, difficulty with urination.
Antihistimines
meclizine
Use = prevent motion sickness related to vomiting.
MOA = inhibit vestibular input to the CTZ (chemoreceptor trigger zone)
AE = dizziness and sedation
Prokinetic Drugs
metoclopramide
Use = produce central and peripheral antiemetic effects; for chemo related vomiting
MOA = Block dopamine in CTZ
AE = sedation, diarrhea, weakness, prolactin release; long term use –> extrapyramidal symptoms, motor restlessness; hypotension/hypertension and tachycardia
Serotonin Blockers
ondansetron
Use = prevent vomiting
MOA = block serotonin receptors in GI tract, CTZ, and vomiting center
AE = HA, dizziness, diarrhea
Absorbants
bismuth subsalicylate (Pepto-bismol) attapulgite (Kaopectate)
Use = diarrhea
MOA = binds to bacteria causing diarrhea to carry them out with feces.
AE = aspirin products: use with caution in children recovering from flu/chickenpox. Increased bleeding time, GI bleed, tinnitus; decreased effectiveness of many drugs
Anticholinergics as an antidiarrheal
Use = diarrhea
MOA = reduce peristalsis of GI tract
AE = b/c of AE it is rarely first choice
Can’t see, can’t spit, can’t pee, can’t shit
Intestinal Flora Modifiers
Use = diarrhea
MOA = bacterial products obtained from lactobacillus organism.
AE = normally resides in intestines to keep bad bacteria in check.
Opiates
diphenoxylate (Lomotil)
Use = diarrhea; can help reduce pain
MOA = slow transit time in intestines = absorption of water and electrolytes.
AE = Sedation, dizziness, constipation, nausea, vomiting, respiratory depression, urinary retention, hypotension, bradycardia.
Lomotil has added atropine to prevent recreational opiate use.
Bulk forming laxative
methycellulose (Citrucel)
Use = constipation
MOA = increase water absorption –> softens and increases bulk intestinal contents
AE = relatively safe and non-habit forming; not for individuals with abdominal pain, N/V
Hyperosmotic laxative
lactulose polyethylene glycol (miralax)
Use = constipation
MOA = creates gradient that draws fluid into colon to increase stool fluid content and stimulate peristalsis
AE = abdominal bloating, rectal irritation, electrolyte imbalance
Saline laxative
Use = constipation
MOA = pressure pushes water/electrolytes into intestines
AE = Salts may cause issues with individuals with diminished cardia or renal function.
Emollient
docusate sodium (Colace)
Use = constipation “fecal softener”
MOA = facilitate water and fat absorption into stool, lubricate fecal matter and intestinal wall.
AE = skin rash, decreased vitamin absorption, electrolyte imbalance; usually well tolerated.
