Medication & Treatment Flashcards
Monitoring needed in long-term PPI use (3)
magnesium
calcium
B12
Long-term risks of PPIs (2)
osteoporosis
renal dysfunction
Metoclopramide dose (gastroparesis)
10-15 mg 3-4 times daily
Botox dose (achalasia, esophageal spasms)
100-200 units at LES
Dantrolene dose (diffuse esophageal spasm)
25 mg qday, increase as needed
Lansoprazole brand name
prevacid
Lansoprazole (prevacid) dose
15-30 mg daily
Potential drug interaction with pantoprazole (protonix)
clopidogrel
Mesalamine brand names (2)
asacol
lialda
Mesalamine dose (UC, Crohn’s)
2.4-4.8 g daily
Infliximab brand name
remicade
Infliximab dose (UC, Crohn’s)
5-10 mg/kg q8 weeks
Adalimumab brand name
humira
Adalimumab dose (UC, Crohn’s)
160 mg then 80 mg
Vedolizumab brand name
entyvio
Vedolizumab dose (UC, Crohn’s)
300 mg q4-8 weeks
Ustekinumab brand name
stelara
Ustekinumab dose (UC, Crohn’s)
130 mg initial then 90 mg q8-12 weeks
Linaclotide brand name
linzess
Linaclotide dose (IBS-C)
145 mcg daily
Lubiprostone brand name
amitiza
Lubiprostone dose (IBS-C, chronic idiopathic constipation)
8-24 mcg BID
Rifaximin brand name
xifaxan
Rifaximin dose (IBS-D, hepatic encephalopathy)
550 mg BID for 14 days
Budesonide brand name (2)
entocort
uceris
Budesonide dose (UC, Crohn’s)
9 mg daily
Lab monitoring needed for long-term budesonide treatment
bone density
Prednisone brand name
deltasone
Prednisone dose (severe IBD, autoimmune hepatitis)
40-60 mg daily
Ursodiol brand name
actigall
Ursodiol dose (PBC)
300 mg BID
Promethazine brand name
phenergan
Promethazine dose (N/V)
25 mg q4-6 hours prn
Loperamide dosing
2-4 mg prn
Maximum daily loperamide dose
16 mg
Hyoscyamine brand name
levsin
Hyoscyamine dose (IBS, abdominal cramps)
0.125-0.25 mg q4h prn
Dicyclomine brand name
bentyl
Dicyclomine dose (IBS - cramping)
10-20 mg QID
Metronidazole dose (C. diff, intra-abdominal infections)
500 mg TID for 10-14 days
Ciprofloxacin dose (infectious diarrhea)
500 mg BID for 7-14 days
Plecanatide brand name
trulance
Plecanatide dose (IBS-C, chronic idiopathic constipation)
3 mg daily
Alosetron brand name
lotronex
Alosetron dose (severe IBS-D in women)
0.5-1 mg BID
Risk associated with alosetron
ischemic colitis
Tacrolimus brand name
prograf
Tacrolimus dose (refractory IBD)
0.05-0.2 mg/kg daily
Azathioprine brand name
imuran
Azathioprine dose (IBD, autoimmune hepatitis)
1-2.5 mg/kg daily
6-mercaptopurine brand name
purinethol
6-mercaptopurine dose (IBD - maintenance only)
1-1.5 mg/kg daily
Eluxadoline brand name
viberzi
Eluxadoline dose (IBS-D)
75-100 mg BID
Bezlotoxumab (zinplava) dose (prevention of C. diff recurrence)
10 mg/kg IV once
Erythromycin dose (gastroparesis)
250-500 mg TID
Octreotide dose (variceal bleed, neuroendocrine tumor)
50-100 mcg SC BID
Methotrexate dose (Crohn’s)
15-25 mg weekly
Balsalazide brand name
colazal
Balsalazide dose (UC)
2.25 g TID
Major benefit of balsalazide
targeted colonic release
Natalizumab (tysabri) dose (refractory Crohn’s)
300 mg q4 weeks
Infliximab (remicade) MOA
TNF-alpha inhibitor
Adalimumab (humira) MOA
TNF-alpha inhibitor
Vedolizumab (entyvio) MOA
integrin inhibitor
Ustekinumab (stelara) MOA
IL-12 and IL-23 inhibitor
Tofacitinib brand name
xeljanz
Tofacitinib (xeljanz) MOA
janus kinase inhibitor
Tofacitinib dose (moderate to severe UC)
xeljanz: 10 mg BID for 8 weeks, then 5 mg
xeljanz XR: 11 mg once daily
Monitoring required for tofacitinib (xeljanz)
monitoring for thrombosis
PO regimen for diverticulitis
500 mg cipro BID + 500 mg metronidazole TID x 7-10 days
Non-severe C. diff treatment
vancomycin 125mg QID x 10 days
Severe C. diff treatment
vancomycin 500 mg QID + IV metronidazole
Microscopic colitis treatment
budesonide 9 mg/day for 6-8 weeks
Amoxicillin dose (H. pylori eradication)
1000 mg BID
Sucralfate dose
1 g QID
Metoclopramide dose
10 mg TID
Giardia treatment
metronidazole 250-500 mg TID for 5-7 days
Amebiasis treatment
1) metronidazole 750 mg TID for 7-10 days then
2) iodoquinol 650 mg TID for 20 days
PPI and its dose for Zollinger-Ellison Syndrome
omeprazole 60 mg BID
H. pylori quadruple therapy
1) PPI BID (omeprazole 20mg, lansoprazole 30mg, pantoprazole 40mg, esomeprazole 40mg)
2) bismuth subsalicylate 524mg QID
3) antibiotic #1 (tetracycline 500mg QID)
4) antibiotic #2 (metronidazole 500mg TID or clarithromycin 500mg BID)
Docusate MOA
surfactant
Miralax MOA
osmotic laxative
PPI drip rate in upper GI bleed
8 mg/hr
Gut-specific biologic
vedolizumab (entyvio)
Common screening not needed for vedolizumab (entyvio)
TB
Upadacitinib brand name
rinvoq
Upadacitinib (rinvoq) MOA
JAK-1 selective inhibitor
UC specific biologics (2)
tofacitinib (xeljanz)
upadacitinib (rinvoq)
Risankizumab brand name
skyrizi
Risankizumab (skyrizi) MOA
IL-23 (p19 subunit) inhibitor
Biologic that is Crohn’s specific
risankizumab (skyrizi)
Most sedating TCA
amitriptyline
TCA for IBS w/ best side-effect profile
desipramine
Best TCA for IBS-C
desipramine
PPI w/ best absorption
esomeprazole
Upadacitinib (rinvoq) MOA
selective JAK1 inhibitor
Risankizumab (skyrizi) MOA
selective IL-23 inhibitor
Tofacitinib (xeljanz) MOA
JAK1/3 inhibitor
Medication particularly helpful for postprandial abdominal pain
dicyclomine
Three most common medication classes for causing microscopic colitis
NSAIDs
PPIs
SSRIs
IBS-D medication only indicated in women
alosetron (lotronex)
Post-ERCP indomethacin dose
100 mg