8- GI Related Drugs

Question 1

What are places that GI drugs can be seen?

Answer 1

• ICUs
• Emergency Rooms
• Operating Theatres

Question 2

GI and ICU Goals

What are goals of these drugs in ICU? (4)

Answer 2

1. Prevent ulvers
2. Prevent + Treat constipation
3. Treat diabetes (stress induced)
4. Promote early feeding + adequate nutrition

Question 3

GI and OR Goals

What are the 4 goals of these drugs in the OR?

Answer 3

1. Promote gastric emptying + motility before surgery
2. Prevent + ↓Nausea
3. Prevent ulcers
4. ↓ risk of aspiration

Question 4

Who is at greater risk of developing ulcers?

Answer 4

• Critically ill patients (ventilated 48+ hrs)

Question 5

When do ulcers occur?

Answer 5

When the mucusal lining protecting stomach cells are disrupted/damaged
- Leads to gastric fluid exposure (low pH)

Question 6

What symptoms can occur from ulcers?

Answer 6

Erosion + Pain + Bleeding + Perforation

Question 7

Ulcer Prevention Drugs

What are 2 classes of drugs that are used to prevent ulcers?

Answer 7

1. H2 anti-histamines
2. Gastric PPIs

Question 8

H2 Anti-Histamines

What do they do?

Answer 8

• Block H2 receptors –> ↓acid made –> ↓chance of ulcer formation

H2 receptors found in stomach wall lining

Question 9

H2 anti-histamines

What is an example of a drug in this category?

Answer 9

Zantac (Ranitidine)

Question 10

Gastric PPIs

What do they do?

Answer 10

They block the H+ pump that produces stomach acid.
- leads to ↓damaged mucosa and ↓ chance of ulcer forming

Question 11

Gastric PPIs

What are 2 drugs that fall under this category?

Answer 11

1. Nexium
2. Pantaloc (Pantoprazole)

Question 12

Why does gastric motility become an issue in ICUs and ORs?

Answer 12

Patients receive drugs that slow it down.
- Ex: Opioids + Sedatives + Muscle paralytics

Question 13

Gastric Motility Agents

They promote forward flow. What can they be helpful with? (2)

Answer 13

1. Help ensure empty stomach pre-operation
2. Combat negative motility affects of other drugs

Question 14

Gastric Motility Agents

What is an example of a drug in this?

Answer 14

Maxeran (Metoclopramide)

Question 15

What are common drugs used to relieve constipation? (3)

Answer 15

1. Peg-Lyte
2. Docusate
3. Lactulose

Question 16

Lactulose

What can this drug do besides help with motility? How does it do it?

Answer 16

• Helps treat ↓LOC in patients w/ liver failure
• Removes built up ammonia

Question 17

Activated Charcoal

When do you use this?

Answer 17

When toxic agents are ORALLY taken

Question 18

Activated Charcoal

What does it do?

Answer 18

Absorbs noxious substances onto its surface, preventing absorption from GI tract.
- Timing of when given to help with OD very important!

Question 19

Activated Charcoal

What can it NOT absorb?

Answer 19

1. Alcohols
2. Metals
3. Acids + Bases
4. Solvents