GI Pharm Flashcards
Migraine neurotransmitter and recommended antiemetic
Dopamine
HA + Nausea => Metoclopramide (Reglan) or Prochlorperazine (Compazine)
Nause => oral Reglan, Compazine, Zofran
Vestibular nausea neurotransmitter and antiemetic
Histamine, acetylcholine
Antihistamines and anticholinergics
Pregnancy neurotransmitter and antiemetic
Unknown neurotransmitter
Promethazine (Phenergan) 1st line
Serotonin antagonist and corticosteroids 2nd line
Gastroenteritis neurotransmitter and antiemetic
Dopamine, serotonin
Dopamine antagonists 1st line
Serotonin antagonists 2nd line
Post-op N/V neurotransmitters and antiemetic
Dopamine, serotonin
Prevention => serotonin antagonist, dexamethasone
Treatment => dopamine antagonists, serotonin antagonists, dexamethasone
Antacids
Magnesium salts (Maalox, Almag)
Aluminum salts (Acid-gone, Gaviscon)
Calcium carbonate (Tums, Rolaids, Alka-mints)
Use caution with renal insufficiency
H2 Blockers
-tidine
Treat PUD, GERD, manage dyspepsia - block histamine receptor on parietal cell
Cimetidine has a lot of side effects - don’t want to use
Don’t take w/ other antacids or meds
Proton Pump Inhibitors
-prazoles
Treat all acid-related disease
Irreversibly binds and blocks proton pump to block acid secretion
Long-term therapy increases risk of infection, fracture, malabsorption (B12, Magnesium, Iron)
PPI highest and lowest DI
Pantoprazole has lowest amount of drug interactions
Omeprazole/esomeprazole have highest number
-also BBW for use with clopidogrel
Sulcrafate (Carafate)
Prevent chemical mucosal damage and heals chronic ulcers
Watch for Aluminum toxicity, don’t give with aluminum-based antacids in renal failure pts OR with citrate in normal kidneys -50X absorption
Bismuth
Suppress H. pylori infection
No effect if not H. pylori
Misoprostol (Cytotec)
Prevent and treat NSAID-induced ulcers
No 1st line, Pregnancy X - BBW miscarriage
Prokinetic
Metaclopramide (Reglan)
1st line for gastroparesis < 12 weeks
Also short-term antiemetic (5-HT3)
Irreversible Tardive Dyskinesia with chronic use
Lots of DI
Antiemetics
Anticholinergics -> M1
Antihistamines -> H1
Dopamine receptor antagonists -> D2 at least
Serotonin 5HT3 Antagonists -> 5HT3
Anticholinergics
Scopolamine
M1
Used for motion sickness - transdermal patch
Antihistamines
H1 blockers
Used for motion sickness
Cause sedation
Dopamine receptor antagonists
Phenothiazines (Phenergan, Compazine)
Benzamides (Metachlopramide, Trimethobenzamide)
Phenothiazines
Phenergan, Compazine (also an antihistamine)
D2, H1, M1 antagonists
SE: Tardive dyskinesia, anticholinergic SE
Caution w/ elderly, CNS depressants, seizures, liver dysfunction
Benzamides
Metoclopramide (Reglan)
-D2, weak 5HT3 block w/ high dose
Trimethobenzamide (Tigan)
-Works centrally in medulla oblongata -> less SE and most potent antiemetic
Serotonin 5HT3 Antagonists
Ondanetron (Zofran)
Central 5HT3 blockage
Great for post-op/chemo-induced nausea, not great for vertigo
Infectious Antidiarrheal Empiric therapy
PO fluoroquinolones - Ciprofloxacin 500 mg BID 3-5 days
PO Macrolides - Azithromycin 500 mg qd 3 days
