GI

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Author:
Mundi
ID:
253690
Filename:
GI
Updated:
2013-12-18 01:44:47
Tags:
GI drugs
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Description:
Drugs affecting the GI tract
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  1. H2 Antagonists
    • Cimetidine
    • Famotidine (Pepcid)
    • (-tidine)

    • MOA: blocks release HCL
    • ↓ gastrin, ↓ pepsin prod


    Ind: short term ulcer; pathological hypersecretory (Zolliner-Ellison); prophylaxis; erosive gastroesophageal reflex; relief heartburn, acid indigestion, sour stomach

    AE: slowing GI effects; cardiac arrhyhmias & hypotension, CNS effects

    • Caution: preg & lact
    • hepatic or renal dysfunction

    D2D: heart drugs, benzo, alcohol
  2. Antacids
    Sodium Bicarbonate (Tums)

    MOA: neutralize stomach acid

    Ind: upset stomach assoc hyperacidity/hyperactivity

    Caution: conditions exacerbate elec imbalance


    AE: acid-base imbalances, hypercalcemia, hypophosphatemia, constip/diarr

    D2D: affects absorption of other drugs
  3. Proton Pump Inhibitors
    P: Omeprazole

    MOA: @secretory surface receptors to prev final step of acid prod

    • Ind: short-term treat ulcers in hypersecret; long-term patholog hypersecret
    • combo w/amoxcillin for H.pylori infection

    • AE: Upper respiratory (cold-like, epistaxis)
    • tongue atrophy, skin effects, hair loss

    • *Take on empty stomach
    • *D/N CHEW
  4. Antipeptic Agent (no prototype)
    MOA: forms ulcer-adherent complex @ ulcer sites

    Caution: preg & lact

    AE: GI effects, dry mouth, dizzy, sleepy, vertigo, skin rash, back pain
  5. Prostaglandin (no prototype)
    MOA: inhibit gastric secretion; ↑ bicarbonate & mucous prod in stomach


    Ind: prevent NSAID induced ulcers, duodenal ulcers

    *CONTRA: PREG (miscarriages)

    AE: GU effects (bleeding, cramping, menorrhea abnormal)
  6. Laxatives
    • Uses: 
    • short term relief constipation
    • prevent straining
    • diagnostic procedures
    • remove ingested poisons
    • adjunct to antihelmintic therapy

    • AE:
    • GI effects
    • CNS (dizzy, headache, weakness
    • CV (due to elec and H2O imbalance)
    • -sweating, palpit, flushing, faint
    • dependency 

    • D2D:
    • interfere w/ timing/process absorption
  7. Laxatives: chemical stimulants
    • Castor Oil
    • Bisa Codyl

    MOA: direct stim nerve plexus in intestinal wall
  8. Laxatives: Bulk Stimulants
    • Polycarbophil (Fibercon)
    • Mg Citrate, sulfate, hydroxide
    • Lactulose
    • Psyllium

    MOA: ↑ bulk, stim local strecth receptors to activate activity
  9. Laxatives: Lubricating stimulants
    • Mineral Oil
    • Colace

    MOA: forms slippery coat; absorb less H2O

    • *best to prevent straining
    • *Monitor vitamin imbalance
  10. Antidiarrheals
    • Loperamid (Imodium)
    • Pepto-bismol (+ painful BM)

    MOA: slows GI motility thru direct action on muscle lining

    Ind: diarr relief, reduc of vol of discharge from ileostomies; traveller's diarrhea

    AE: slowing GI effects; toxic megacolon

    • Caution:
    • Preg & lact
    • Hx GI obstruc
    • Hx acute abdom condition
    • Diarrhea due to poisoning

    *determine cause of diarrhea
  11. Antiemetic: Phenothiazine
    Prochlorperazine

    MOA: ↓ various areas of CNS (CTZ in medulla)


    AE: urine pink - red-brown
  12. Antiemetic: Nonphenothiazine
    Metoclopramide

    MOA: ↓ activity on nerve cells in CTZ that induce vomiting


    AE: extrapyramidal symptoms
  13. Antiemetic: Serotonin Receptor Blockers
    Ondansetron

    MOA: blocks CTZ receptors assoc w/ NV; also locally

    AE: headache, myalgia, urin reten
  14. Antiemetic: Anticholinergic/Antihistamines
    • Meclizine
    • *motion sickness

    • MOA: anticholinergic
    • AE: anticholinergic effect (urin freq, dry mouth, confusion, anorexia)
  15. Antiemetic: Substance P/Neurokinin 1 Receptor Antagonist
    Aprepitent

    AE: liver enzyme elevation, dehydration

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