GI System Meds

Question 1

G promethazine

B Phenergan

Answer 1

Phenothiazine; antiemetc, also tx of motion sickness; antihistamine, anesthesia & analgesia adjunct

SE: sedation, anticholiner-gic effects (dry mouth, blurred vision, constipation, urinary retention); orthostatic hypotension

Question 2

G metoclopramide

B Reglan

Answer 2

Antiemetic and GI stimulant (reduces gastric stasis)

SE: generally well tolerated; drowsiness; limit use to 12 wks to decrease risk of EPS, NMS (w/increased fever, muscle rigidity)

Question 3

G diphenoxylate w/atropine

B Lomotil

Answer 3

Anti-diarrheal

Schedule V drug due to opioid composition; limit to 4 doses (1-2 tabs/dose) in 24 hr period

SE: drowsiness, rash; anticholinergic effects

Question 4

G biscodyl

B Dulcolax

Answer 4

Laxative, stimulant cathartic

Available in PO and suppository form

SE: anorexia; poss GI cramping, diarrhea

Question 5

G magnesium hydroxide

B Milk of Magnesia

Answer 5

Laxative, osmotic cathartic
Antacid in smaller dose

Due to Mg+ content, not recommended for renal pt; increase fluids to prevent dehydration

SE: loose BMs

Question 6

G psyllium

B Metamucil

Answer 6

Bulk forming laxative

Take w/full cup of water or juice

SE: poss GI cramping; esoph or intestinal obstruction (use w/plenty of fluid); loose BMs, flatus

Question 7

G docusate sodium

B Colace

Answer 7

Stool softener, surfactant laxative

May take 2 days for effect

Question 8

G aluminum hydroxide

B Amphojel, AlternaGEL

Answer 8

Antacid

Give 1 hr before or 2 hrs after other meds, between meals and hs

SE: constipation esp w/long term use; hypophostatemia

Question 9

G simethicone

B Gas-X, Mylicon

Answer 9

Anti-flatulant

Not recommended for infant colic;

no known significant SE

Question 10

G ranitidine

B Zantac

Answer 10

H2 inhibitor; anti-ulcer; for tx of PU, GERD; prevention of stress ulcers

SE: generally well tolerated; may increase risk of pneumonia as decreased gastric acid causes increased risk of gastric bacterial colonization, spread

Question 11

G lansoprazole

B Prevacid

Answer 11

Proton pump inhibitor; anti-ulcer; preferred for tx of PU, GERD; prevention of stress ulcers

SE: H/A, nausea, diarrhea; may increase risk of pneumonia as decreased gastric acid causes increased risk of gastric bacterial colonization, spread

Question 12

G lansoprazole, clarithromycin, & amoxicillin

B Prevpac

Answer 12

Proton pump inhibitor and anti-infective combination for tx of Helicobacter pylori

Tx course usually 2 wks

SE: nausea & diarrhea from the antibiotics

Question 13

G sulcrafate

B Carafate

Answer 13

GI mucosal protectorant; for tx of ulcers, IBD

Give on empty stomach 1 hr ac and at hs; may give tablet dissolved in 1 oz water as “slurry”

SE: constipation

Question 14

G misoprostol

B Cytotec

Answer 14

Prostaglandin analogue, antiulcer, cytoprotective agent; helps prevent NSAID-induced gastric ulcer

SE: N&V, gastric upset, diarrhea, menstrual spotting; contraindicated in pregnancy

Question 15

G pancrelipase

B Pancrease, Viokase

Answer 15

Pancreatic enzyme

Taken w/meals, snacks

SE: generally well tolerated; possible allergic reaction

Question 16

G inflixamab

B Remicade

Answer 16

Immunosuppressant, GI anti-inflam- matory MAB; tx of IBD (Crohn’s & UC); also for other inflammatory conditions as rheumatoid arthritis

DMARD

SE: H/A, N&V, rash; bone marrow suppression, increased risk of infection (esp URI), alopecia; hepatotoxicity

Question 17

G mercaptopurine (6MP)

B Purinethol

Answer 17

Immunosuppressant; tx of IBD (Crohn’s & UC); anti-neoplastic antimetabolite in larger doses

SE: N&V, rash, bone marrow suppression, increased risk of infection; hepatotoxicity