GI Flashcards
(14 cards)
Prokinetic Agents: Metoclopramide (Reglan)
-good for post op and chemo induced n/v
-Oral form for diabetic gastroparesis and GERD
-Extrapyramidal symptoms can be bad give Benadryl
-can be sedating
IBS-D medication: Alosetron (Lotronex)
-MOA: increase firmness of stool, decrease urgency and freq of defecation
-approved for females with severe IBS-d lasting longer than 6 mths and other meds do not work
-can cause GI toxicity: need pt to understand and sign about this risk, stop taking if bleeding or ab pain
-contraindication: major bowel conditions (IBD)
IBS-C medication: Lubiprostone (Amitiza)
-promotes intestinal motility (maybe diarrhea)
-take with food
IBD medication: Sulfasalazine (Azulfidine)
-lots of other med options (steroids, immunosupp, immunomodulators)
-MOA: 5-aminosalicylate that inhibits prostaglandin synthesis causing decrease inflam
-Treats Crohn’s and mild-moderate acute episodes of UC
Probiotics
-various preps for normal flora
-helps metabolize food, promote nutrient absorption, and reduce bad bacteria
-good to use with antibiotics, IBS, IBD, C-diff, rotavirus, norovirus, etc
PPI: Omeprazole, Esomeprazole, Lansoprazole
-for hiatal hernia
-block final step of gastric acid production to prevent reflux into hiatal hernia
-short term for ulcers, GERD, esophagitis (4-8wks)
-long term for hypersecretory conditions, bone fractures, kidney disease, vit b12 deficiency, and dementia
Antacids: Aluminum hydroxide, sodium bicarbonate, calcium carbonate
-for hiatal hernia, PUD, ulcers, GERD
-neutralizes gastric acid to provide relief of manifestations (heartburn, gas, dysphagia)
Iron
-side effects: GI distress, teeth staining in liquid form, IM (give z-pack or avoid), anaphylaxis, hypotension, toxicity in children my be fatal
- take with food, avoid caffeine/diary (interferes with absorption)
-vit C helps with absorption (orange juice with it)
Vit B12
-necessary to convert inactive folic acid to active form
-those with malabsorption issues may need monthly IM injections for life
-side effects: hypokalemia, GI distress, monitor levels
Histamine 2-receptor antagonist (Cimetidine/Famotidine)
-treats ulcers, GERD, heartburn, good for allergic reactions involving GI or anaphylaxis (give IV pepcid)
Mucosal Protectant: Sucralfate
-ulcers and protection of stomach from acid in n/v
Prostaglandin E analog: Misoprostol
-prevents gastric ulcers in long-term NSAID use
Laxatives: constipation
-Psyllium, methylcellulose- Bulk forming laxatives (soften mass and increase bulk)
-Docusate sodium- Surfactant laxative (lower surface tension in stool to allow penetration of water)
-Bisacodyl, senna- Stimulant laxative (stimulate peristalsis and increase water in intestines)
-Magnesium hydroxide, lactulose- osmotic laxative (draws water in intestine to increase mass of stool, stretching musculature)
Complications: fluid retention, dehydration, sodium absorption, obstruction, toxic mg levels, rectal burning, GI irritation
Antidiarrheals
-Diphenoxylate + Atropine (Lomotil)
-Loperamide (Imodium)
-decrease intestine motility and increase absorption of water and sodium
