NSAIDS, GI Flashcards
Analgesic for active PUD
acetaminophen or opioids (codeine)
Best for UC (IBD)
Sulfasalazine (5-aminosalicylic acid plus sulfapyridine)
Rescue inhaler
Short acting Beta 2 agonists
Decreasing aspirin sensitive asthma
Zileuton (leukotriene inhibitor)
OTC osmotic laxative for occasional constipation
Miralax (polyethylene glycol)
Most potent NSAIDs, but have the worst side effects
Indomethacin
Phenylbutazone
Reduces pain and inflammation in acute gout attacks
Colchicine
To rapidly clear stomach contents
Erythromycin
Antidote to Acetaminophen intoxication
N-acetylcysteine
administered parenterally within 10-12 hours
DOC NSAID for gout
Indomethacin
Chronic use causes vasoconstriction and CNS effects
Ergotism (St anthony’s fire)
Make your tongue and stool black
Bismuth subsalicylate
Can cause severe hypersensitivity because the enzyme is not found in humans
Urate oxidase enzymes: Rasburicase Pegloticase (presumably)
Analgesic if no history of PUD
NSAID
To prevent or reduce NSAID-induced damage
Misoprostol
Give in patients that had an inadequate response or intolerance to methotrexate
Tofacitinib
Reduce absorption of aspirin
Antacids
NSAID for closing the patent ductus arteriosus
Indomethacin
Used in combination with 5HT3 antagonists (“setrons”)
NK1 antagonist→ Aprepitant
Long term use decreases colon cancer
Aspirin
Used for IBS
Antispasmodics
Very intense mucosal agent
Castor oil
Used for surgery, diagnostic
Castor oil
Reduce inflammation in IBD
Corticosteroids
Migraine prophylaxis
Beta-Blockers→ Propranolol
Calcium Channel Blockers→ Verapamil
Antidepressants
•Amitriptyline (Elavil, Endep)
•Fluoxetine (Prozac)
Clonidine Valproic Acid Topiramate (antiepileptic) Botulinum Toxin Type A+B Angiotensin II receptor blockersk
Increase lower esophageal sphincter tone
Bethanechol
Most widely used treatment for asthma
Short acting Beta 2 agonists
For severe, refractory IBD
Infliximab, adalimumab
TNF-alpha blockers
Give prophylactic colchicine therapy as it can trigger an attack
Xanthine oxidase inhibitors:
Allopurinol
Febuxostat
Utilized for removal of warts, corns, fungal infection, eczematous dermatitis
Salicylic acid (but not aspirin)
Can be used for hirsutism
Cimetidine
avoid in males
NSAID with the longest half life
Naproxen
2 best drugs for motion sickness
Dimenhydrinate
Scopolamine
Treat or prevent ulcers
H2 antagonists
Prep for colonoscopy
Large volume of polyethylene glycol (osmotic laxative) with electrolytes
Analgesic if history of PUD, but not currently active
Celecoxib +/- antacids
NSAIDs + misoprostol or prazoles (PPIs)
Good for antinausea from chemo/radiation, but not good for motion sickness
5HT3 antagonists
“setrons”
Other NSAIDs for gout
Naproxen
Celecoxib
Sulindac
When it comes to chemotherapy, allopurinol increases the effects of ______ and decreases the effect of _______
Increases: mercaptopurines 6-MP and azathioprine
Blocks activation, decreases: Fluorouracil (5 FU)
Prevention, prophylaxis, and decreasing nocturnal asthma.
Always combined with a steroid
Long acting Beta 2 agonists
Expensive, only used for refractory migraine therapy
Triptans
Combined with a xanthine oxidase inhibitor
Lesinurad
Drug of last choice for asthma because of an FDA black box warning about increased death
Long acting beta 2 agonists, study was done on drugs not combined with steroids
Antihistamines for sedation
Diphenydramine
Doxylamine
Hydroxyzine
Also used for Wilson’s disease
Penicillamine
Post-op ileus
Bethanechol
Caution using this analgesic in children (liver toxicity), but often used to reduce fever in children
Acetaminophen
DMARD (JAK kinase inhibitor) that can be used in monotherapy or in combination with methotrexate or non-biologic DMARDS
Barcinitib
Mild mucosal agents (2)
Bisacodyl
Senna
Effective in primary and secondary gout
Xanthine oxidase inhibitors:
Allopurinol
Febuxostat
Drug of last choice for refractory asthma or COPD
Theophylline
IV only, similar to ergotamine but more effective
Dihydroergotamine
DOC among NSAIDs as it has the best side effects profile
Ibuprofen
Post-op analgesia
Ketorelac
For ulcers refractory to H2A
PPIs
MI and thrombosis prophylaxis
Aspirin
The best drugs for motion sickness
Dimenhydrinate (1st gen antihistamine)
Scopolamine (antimuscarinic, not discussed this unit)
While using this DMARD, you have to monitor for hepatitis and bone marrow suppression
(q 2-3 weeks x3 months, then periodically)
Sulfasalazine
Antihistamines for motion sickness prophylaxis
1st gen:
Diphenhydramine
Doxylamine
Promethazine
Antiemetic antihistamine
Promethazine
Use in patients on chronic NSAID therapy to prevent adverse GI effects
PPIs
Diabetic gastroparesis
Erythromycin
H pylori therapy to block acid and kill bacteria (4)
- Pepto-Bismol
- Metronidazole
- ABX: Clarithromycin, tetracycline, amoxicillin
- H2 blocker
Can be used for preanesthesia
H2 antagonists
DOC Zollinger- Ellison
PPIs
Antispasmodic for IBS-D
Eluxadoline (opioid agonist)
Severe allergic reactions should get
Both an H1 (antihistamines) and an H2 blocker (“tidines”)
Decreases the absorption of allopurinol
Aluminum hydroxide
***
Give before starting chemotherapy to prevent a gout attack triggered by tumor lysis syndrome
Rasburicase
Temporary relief of heartburn or gastritis, adjunct therapy
Antacids
For IBS-C
Linaclotide
Mostly used for asthma in children
Cromolyn sodium, nedocromil
Antiemetic used in combination with 5HT3
Aprepitant (NK1 antagonist)
Analgesics for migraines
Aspirin
Acetaminophen
Naproxen
Propoxyphene
Antihistamines for a patient with liver failure
Those excreted by kidneys:
Cetirizine
Levocetirizine
Acrivastine
Best adverse affect profile: Acetaminophen vs ibuprofen
Acetaminophen
Moderate to severe allergic asthma
Omalizumab
Small bowel dysmotility
Erythromycin
Used to stimulate appetite in chemo patients (and reduce nausea)
Cannabinoids
Dronabinol/THC
DMARD that is also used for refractory Non-Hodgkin’s lymphoma
Rituximab
Specifically blocks CD20 antigen expressed on B-cells in non-Hodgkin’s lymphoma.
researching other cancers
NSAID with uricosuric effects
Aspirin
Prevention of hepatic encephalopathy in those with cirrhosis or liver disease
Lactulose
TNF alpha inhibitor approved for monotherapy
most DMARDs combined with methotrexate
Adalimumab
Combined with codeine and derivatives, sedatives, cough
suppressants, tramadol, diphenhydramine, caffeine
Acetaminophen
DOC for GERD with esophagitis
PPIs
TNF alpha inhibitor that also treats Crohn’s disease
Infliximab