GI Medications

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GI Medications
2014-03-02 20:19:37
GI Medications

GI Medications
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  1. Antacids
    • Decreases acid concentration in GI tract and elevate stomach pH>5
    • Take on empty stomach, 1-3 hrs after meals and at bedtime.

    • Magnesium causes diarrhea
    • Aluminum causes constipation and hypophosphatemia.
    • Calcium causes constipation
    • Sodium bicarbonate causes alkalosis.
  2. H2 Receptor Antagonists (ine)
    Cimetidine, Ranitidine, Famotidine, Ranitidine

    • Avoid taking an antacid 1 hour before and 1 hour after H2 blocker
    • Reduces hydrochloric acid in stomach. Used for GERD, heartburn, erosive esophagitis.
    • Do not stop arubtly
    • Drug of choice for PUD - gastric and duodenal ulcers
    • Decreased platelets
  3. Antiulcer
    • Carafate - promotes ulcer healing by adhering to ulcer surface and forming a protective barrier against gastric acid and pepsin
    • Take on empty stomach 1hr before meal
    • Do not crush or chew
    • Other meds should be taken 2 hrs before or after this medication.

    • Pepto-Bismol
    • Antidiarrheal
    • Temporary darkening (gray-black) stool
    • Contains salicylate - observe for tinnitus, give cautiously to children due to possibility of Reyes syndrome
    • Antibacteria action against H. pylori

    • Cytotec - suppresses gastric acid and increase the production of protective mucus
    • Contraindicated in pregnancy
    • Given concurrently with long term NSAIDs to prevent NSAID induced gastric & duodenal ulcers
  4. Proton Pump Inhibitors (PPI) (prazole)
    • Used in GERD, duodenal ulcers, esophagitis and H.pylori infections
    • Most effective drugs for suppressing secretion of gastric acid
    • Can cause irreversible inhibition of gastric acid pump in the stomach
  5. Antiflatuent
    Simethicone (Mylicon, Gas-X)
  6. Pancreatic Enzymes
    • Pancrelipase
    • Monitor stools for high fat content.  Stools will be foul-smelling and frothy if patient does not have enough enzymes
    • Administer immediately before or with meals and snacks
    • Eat immediately after taking medication.  Do not chew tablets, drink with plenty of fluids.
  7. Laxatives
    • Diarrhea
    • Abdominal cramping
    • F&E imbalance
    • Bulk forming laxative must take with fluid.  If taken without adequate fluid it may cause it to swell and block the throat or esophagus and may cause choking
    • Hyperosmolar acts quickly in 6-12 hours or as rapidly as 2-4 hours. 
    • Used for diagnostic tests; colonoscopy
    • can cause substantial water loss
  8. Antiemetics
    • Management of GERD, decrease symptoms of gastric stasis
    • Drowsiness, difficulty speaking or swallowing, loss of balance control

    • Anticholinergic for mild or modere N/V
    • Hypotension

    • Reglan for mild or moderate N/V
    • Uncontrolled rhythmic movement of mouth, face and extremities, lip smacking or puckering

    • Zofran for high or moderate N/V
    • Arrythymias
  9. Corticosteroids (one)
    • Used in ulcerative colitis and Crohn's disease
    • Suppresses the immune system
    • Osteoporosis
    • Infection due to long term use
    • Na and water retention, K loss
    • PUD
    • Puffy face
    • Growth retardation
  10. Aminosalicylates (ine)
    • Used to treat mild or moderate ulcerative colitis or Crohn's disease
    • Belongs to sulfonamides antibiotics
    • Reduces inflammation
    • Take 1 to 2 hrs before meals, full glass of water
    • Blood disorders, Nausea, fever, rash
  11. Immunomodulators
    • For long term treatment of ulcerative colitis and Crohn's disease
    • To induce and maintain remission
    • Acts as immunosuppressant