GI: Medications Flashcards
Magnesium Hydroxide with Aluminum Hydroxide (Maalox, Mylanta)
Antacid; deactivates pepsin, which increases gastric pH; give 2 hours after meals and at bedtime; do not give within 1-2 hours of other medications
Aluminum Hydroxide (Amphojel)
Antacid; deactivates pepsin, which increases gastric pH; give 1 hour after meals and at bedtime; do not give within 1-2 hours of other medications
What’s the difference between antacids that contain aluminum versus ones that contain magnesium?
Aluminum causes constipation, magnesium causes diarrhea; Magnesium contraindicated in renal and cardiac failure
Ranitidine (Zantac)
H2 antagonist; blocks histamine receptors in parietal cells, which decreases gastric acid secretion
Famotidine (Pepcid)
H2 antagonist; blocks histamine receptors in parietal cells, which decreases gastric acid secretion
Nizatadine (Axid)
H2 antagonist; blocks histamine receptors in parietal cells, which decreases gastric acid secretion
Omeprazole (Prilosec)
PPI; suppresses gastric acid secretion
Pantoprazole (Protonix)
PPI; suppresses gastric acid secretion; IV form is not compatible with most other drugs; SR, used for duodenal ulcers
Rabeprazole (Aciphex)
PPI; suppresses gastric acid secretion; SR, used for duodenal ulcers
Esomeprazole (Nexium)
PPI; suppresses gastric acid secretion; give 1 hour before meals
Misoprostol (Cytotec)
Prostaglandin analog; decreases gastric acid secretion, increases resistance to mucosal injury from NSAIDs; not to be used with magnesium containing antacids (both cause diarrhea)
What’s the drug class of choice for treating patients with acid-related disorders?
PPIs
Why should PPIs not be used for a prolonged period of time?
They may contribute to osteoporotic-related fractures
Sucralfate (Carafate)
Mucosal barrier fortifier; forms protective coat to prevent further digestive action of pepsin, gastric acid
Psyllium Hydrophilic Mucilloid (Metamucil)
Bulk-forming laxative; take at mealtime with glass of water
Loperamide (Imodium)
Antidiarrheal
Clarifenacin (Enablex)
Muscarinic-receptor antagonist; inhibits intestinal motility
Festoterodine (Toviaz)
Muscarinic-receptor antagonist; inhibits intestinal motility
5-fluorouracil (5-FU)
Chemotherapy; used for colorectal cancer
Diphenoxylate Hydrochloride with Atropine Sulfate (Lomotil)
Antidiarrheal; reduces GI motility; not for elderly, may contribute to falls; not for gastroenteritis, must get virus or bacteria out of GI system
Dicyclomine Hydrochloride (Bentyl)
Anticholinergic; inhibits gastric motility
Sulfasalazine (Azulfadine)
Aminosalicylate (5-ASA); inhibits prostaglandins to reduce inflammation; contraindicated with sulfonamide allergies and thiazide diuretics; may cause hemolytic anemia, agranulocytosis
Mesalamine (Asacol, Pentasa, Rowasa)
Aminosalicylate (5-ASA); inhibits prostaglandins to reduce inflammation
Olsalazine (Dipentum)
Aminosalicylate (5-ASA); inhibits prostaglandins to reduce inflammation
Balsalazide (Colazal)
Aminosalicylate (5-ASA); inhibits prostaglandins to reduce inflammation
Prednisone (Deltasone)
Glucocorticoid; can cause hyperglycemia, osteoporosis, peptic ulcer disease, increased risk for infection
Infliximab (Remicade)
Immunomodulator; reduces activity of tumor necrosis factor (TNF) to decrease inflammation; used in combination with glucocorticoids for treatment of UC or Crohn’s; avoid crowds, anyone with infection; parenteral only
Adalimumab (Humira)
Immunomodulator; reduces activity of tumor necrosis factor (TNF) to decrease inflammation; used in combination with glucocorticoids for treatment of UC or Crohn’s; avoid crowds, anyone with infection; provide teaching for subcutaneous injection
Natalizumab (Tysabri)
Immunomodulator; reduces activity of tumor necrosis factor (TNF) to decrease inflammation; for use in Crohn’s; avoid crowds, anyone with infection; parenteral only; report cognitive/motor/sensory changes immediately
Certolizumab Pegol (Cimzia)
Immunomodulator; reduces activity of tumor necrosis factor (TNF) to decrease inflammation; for use in Crohn’s; avoid crowds, anyone with infection; parenteral only
What types of medications are avoided for a patient with diverticulitis?
Laxatives & enemas because they increase intestinal motility, causing increased inflammation
Furosemide (Lasix)
Loop diuretic; causes potassium loss
Spironolactone (Aldactone)
Potassium-sparing diuretic
Propranolol (Inderal)
Beta-blocker; decreases HR and hepatic venous pressure gradient to decrease GI bleed
Octreotide (Sandostatin)
Synthetic somatostatin; reduces portal pressure to decrease GI bleed
Terlipressin
Vasopressin; reduces portal pressure to decrease GI bleed
Lactulose (Evalose, Heptalac)
Laxative; promotes excretion of ammonia in stool
Pancrelipase (Creon)
Pancreatic enzyme replacement therapy (PERT); do not crush or chew; if capsules must be opened for difficulty swallowing, mix in applesauce; do not mix with high protein food because enzymes will dissolve
Orlistat (Xenical)
Anorectic; suppresses appetite, inhibits lipase for partial digestion of triglycerides (decreased calories); causes GI symptoms unless fat is reduced below 30% of daily food intake
Phentermine (Adipex-P)
Sympathomimetic; suppresses appetite in hypothalamus
