GI Medications

Question 1

Bulk Forming Laxative

Metamucil (psyllium fiber supplement)

Answer 1

Stool softener - absorbs liquid and creates a softer bulkier stool that is easier to pass

Uses: constipation, irregularity

Side effects: belly pain, bloating, stomach cramp
s
Contraindications: blocked intestine, difficulty swallowing, fecal impaction, nausea, vomiting, fever or abdominal pain, undiagnosed rectal bleeding

Question 2

Saline Laxatives

Milk of Magnesia (magnesium hydroxide)
Magnesium Citrate

Answer 2

Increases water in the intestines which may induce defecation
Uses: constipation, irregularity, antacid, indigestion, sour stomach and heartburn
Side effects: bad taste in mouth, diarrhea, dehydration, electrolyte abnormalities
Contraindications: blocked intestine, belly pain, upset stomach, change in bowel habits lasting longer then 2 weeks, kidney disease

Question 3

Osmotic Laxatives

Miralax (polyethelyne glycol, PEG, electolyte free)

GoLytely (polyethelyne glycol and electrolyte solution)

Lactulose

Answer 3

Increase the amount of fluid secreted within the intestines resulting in softer and easier to pass stools
Uses: constipation, irregularity
Side effects: bloating, gas, upset stomach, dizziness, increased sweating
Contraindications: blocked intestine, belly pain, upset stomach,nausea/vomiting with severe stomach pain, change in bowel habits lasting longer then 2 weeks, kidney disease, anorexia, bulimia, ulcerative colitis, IBS

Question 4

Stool Softener (surfactant)

Colace (docusate sodium)

Answer 4

Softens stool making it easier to pass
Uses: treat or prevent constipation, reduce pain or rectal damage caused by hard stools or straining during bowel movements
Side effects: stomach cramps
Contraindications: nausea, vomiting, severe stomach pain, blocked intestine, chronic stomach pain that has not been checked by a doctor

Question 5

Cathartics (stimulant laxative)

Senekot (senna)

Dulcolax (bisacodyl)

glycerin suppositories (faster)

Answer 5

Irritate the muscles of the intestine causing peristalsis, stimulating evacuation of the stool
Do not crush or chew pills
Uses: constipation
Side effects: black, tarry stools, blood in stool, nausea/vomiting, stomach pain
Contraindications: nausea, vomiting, severe stomach pain, blocked intestine, Crohn’s disease or ulcerative colitis, heart disease

Question 6

Anti-diarrheal

Lomotil (diphenoxylate/atropine)

Kaopectate, Pepto Bismol (bismith subsalicylate)

Imodium (loperamide)

Answer 6

Decrease bowel motility, slowing peristalsis, increasing the absorption of water into intestines
Uses: diarrhea
Side effects: flatulence, headache, nausea, dizziness
Contraindications: ulcerative colitis, bloody or tarry stools, diarrhea with a high fever or diarrhea caused by antibiotics

Question 7

Pedialyte (electrolytes)

Answer 7

Replaces electrolytes
Uses: dehydration, add back fluid after fluid loss, prevention of fluid or electrolyte problems
Side effects: vomiting
Contraindications: extreme loss of body water, hyperkalemia, familial hyperkalemic periodic paralysis, Thomsen disease, Complete heart block, severe heart block, stomach muscle paralysis and decreased function, severe renal impairment, hyporeninemic hypoaldosteronism

Question 8

Anti-flatulent

Mylanta (simethicone)

Beano (enzyme alpha-galactosidase)

Answer 8

Alleviates or prevents excess gas
Uses: relieve pain and pressure caused by excess gas in the stomach and intestines
Side effects: no known side effects
Contraindications: phenylkenonuria

Question 9

Enemas

Tap Water, Soap suds - cleansing - retain for 5 to 10 minutes

Normal Saline - 0.9 NS - Fleet (sodium phosphate), Oil retention - retention - retain for 30 to 60 minutes
*Fleet not to be used in patient’s with sodium imbalance

Return flow - large volume of fluid is instilled in 100-200 mL increments, then fluid is drawn out by lowering the container below the level of the bowel. this is repeated 3 to 5 times

*patient should be lying on left side in sim’s position to administer enema

Answer 9

Breaks up stool by inserting water or other liquid through the rectum into the intestines
Not a first line treatment, should try stool softeners or bulk forming laxatives first
Uses: constipation, to introduce drugs for diagnostic testing
Side effects: mild abdominal discomfort, cramps or gas
Contraindications: fecal stones, rectal obstruction by tumor or prolapse, active coronary heart disease, coma

Question 10

Anti-emetics

Zofran (ondansetron)

Reglan (metoclopramide)

scopolamine

Dramamine (dimenhydrenate)

Answer 10

Reduces nausea/vomiting
Uses: motion sickness, side effects of opioid analgesics, general anesthesia and chemotherapy
Side effects: dry mouth, headaches, dizziness

Question 11

GI Meds (antacids)

Usually first line
Zantac (ranitidine)

Tagamet (cimetidine)

Pepcid (famotidine)

Stronger
Prilosec (omeprazole)

Protonix (pantoprazole)

Prevacid (lansoprazole)

Nexium (esomeprazole)

Carafate (sucralfate) - forms protective barrier of stomach lining

Fast acting, short duration
Gaviscon (aluminum hydroxide)

Tums - (calcium carbonate)

Answer 11

Decrease stomach acid, allowing time for GI tract to heal
Uses: prevention and treatment of heartburn, acid reflux or GERD (gastroesophageal disease), peptic ulcers
Side Effects: headache, constipation, diarrhea, difficulty sleeping, dry mouth, dry skin, ringing in ears, runny nose, trouble urinating