GI Meds

Question 0

Neutralize Gastric Hydrochloric Acid
SE: constipation esp. w/long term use; hypophosphatemia
Notes:Give 1 hr before or 2 hrs after other meds, between meals & bedtime Aluminum compounds bind to warfarin (Coumadin) & tetracycline & interfere with absorption

Answer 0

G aluminum hydroxide
B Amphojel, AlternaGEL

Class: Antacid

Question 1

Inhibits GI motility; Limit to 4 doses (1-2 tabs/dose) in 24 hr period SE: drowsiness, rash; anticholinergic effects. ​
Be aware Schedule V drug due to opioid composition

Answer 1

G diphenoxylate w/atropine
B Lomotil

Class: Anti-diarrheal

Question 2

Promotes peristalsis; Reduces gastric stasis. SE: generally well tolerated; drowsiness; limit use to 12 wks to â risk of EPS, NMS (w/á fever, muscle rigidity);Administer IV slowly to prevent EPS. Reverse EPS symptoms by administering diphenhydramine hydrochloride (Benadryl) or benztropine mesylate (Cogentin)

Answer 2

G metoclopramide
B Reglan

Class: Antiemetic; GI stimulant

Question 3

Acts in the stomach & the intestines to disperse & reduce the formation of the mucus-trapped gas bubbles. This defoaming action reduces the surface tension of gas bubbles so that they are more easily eliminated. SE: No known significant. Not recommended for infant colic

Answer 3

G simethicone
B Gas-X, Mylicon

Class: Anti-flatulent

Question 4

Thick substance that forms a protective coating to prevent injury from acid & pepsin. Protective coating may last
for up to 6 hours. Tx of ulcers, IBD
. SE: constipation Give on empty stomach 1 hr ac & at bedtime; may give tablet dissolved in 1 oz water as “slurry”

Answer 4

G sulcrafate
B Carafate

Class: Anti-ulcer (GI mucosal protectant)

Question 5

Inhibits histamine at the H2 receptor sites & decrease acid production ; for tx of PU, GERD; prevention of stress ulcers. SE: generally well tolerated; may á risk of pneumonia as â gastric acid àá risk of gastric bacterial colonization, spread.

Answer 5

G ranitidine
B Zantac

Class: Anti-ulcer (H2 inhibitor)

Question 6

Suppress gastric acid secretion & increase cytoprotective mucus in the GI tract. Also causes a moderate

Answer 6

G misoprostol
B Cytotec

Class: Anti-ulcer (Prostaglandin analogue, cyto-protective agent)

Question 7

Suppress gastric acid by inhibiting the proton pump or the hydrogen ion pump that is located in the gastric parietal cells. Block the final step of acid production.
Preferred for tx of PU, GERD; prevention of stress ulcers.SE: H/A, nausea, diarrhea; may á risk of pneumonia as â gastric acid àá risk of gastric bacterial colonization, spread. Inhibit up to 90% greater than the H2 blockers (histamine antagonists) Lower strengths available OTC.

Answer 7

G lansoprazole
B Prevacid

Class: Anti-ulcer (Proton pump inhibitor)

Question 8

Tx of Helicobacter pylori. SE: nausea & diarrhea from the antibiotics. Course of tx usually 2 wks Assess for allergies to antibiotics.

Answer 8

G lansoprazole,
clarithromycin, &
amoxicillin
B Prevpac

Class: Anti-ulcer (Proton pump inhibitor) & anti-infective (Macrolide) combination

Question 9

DMARD
GI anti-inflammatory MAB; tx of IBD (Crohn’s & UC); also for other inflammatory conditions as rheumatoid arthritis. SE: H/A, N&V, rash; bone marrow suppression, á risk of infection (esp. URI), alopecia; hepatotoxicity. Store in refrigerator, reconstitute.

Answer 9

G inFLIXimab
B Remicade

Class: Biologic response modifiers;
DMARD
GI anti-inflammatory MAB; Immunosuppressant

Question 10

Tx of RA, Crohn’s, UC, psoriasis. SE: bone marrow supp, á risk of infection (esp. URI), neoplasm; HF. Avoid if pt has MS. Refrigerate after reconstitution

Answer 10

G etanercept
B Enbrel

Class: Biologic response modifiers;
DMARD;
Anti-rheumatic drug;
TNF blckr; Immunosuppressant

Question 11

Immunosuppressant; tx of IBD (Crohn’s & UC); anti-neoplastic anti-metabolite in larger doses; leukemias, lymphomas,SE: N&V, rash, bone marrow suppression, á risk of infection; hepatotoxicity.

Answer 11

G  mercaptopurine (6MP)
B  Purinethol

Class: Immunosuppressant,

Question 12

Absorb water in the intestine & make the stool softer. SE: poss. GI cramping; esoph or intestinal obstruction (use w/plenty of fluid); loose BMs, flatus.

Answer 12

G psyllium
B Metamucil

Class: Laxative (Bulk forming)

Question 13

Pulls water into colon & increase water in feces to increase bulk, which stimulates peristalsis. SE: loose BMs. Due to Mg+ content, not recommended for renal pt; á fluids to prevent dehydration.

Answer 13

G magnesium hydroxide
B Milk of Magnesia

Class: Laxative (osmotic cathartic);
Antacid (smaller doses)

Question 14

Available in PO & suppository form. SE: anorexia; poss. GI cramping, diarrhea.

Answer 14

G bisacodyl
B Dulcolax

Class: Laxative (Stimulant cathartic)

Question 15

Facilitates digestion of carbohydrates, fats, & proteins. SE: generally well tolerated; possible allergic reaction. Taken w/meals, snacks

Answer 15

G pancrelipase
B Pancrease, Viokase

Class: Pancreatic enzyme

Question 16

Tx of motion sickness; antihistamine, anesthesia & analgesia adjunct. SE: sedation, anticholinergic effects (dry mouth, blurred vision, constipation, urinary retention); orthostatic hypotension. May cause a harmless pinkish to brown urine color Very irritating to veins; dilute IV dose.

Answer 16

G promethazine
B Phenergan

Class: Phenothiazine; anti-emetic

Question 17

Moisten the stool & prevent dehydration. May take 2 days for effect. OTC

Answer 17

G docusate sodium
B Colace

Class: Stool softener: Laxative (surfactant)