GI Disease Medications

Question 1

What is the purpose of antacids?

Answer 1

provide rapid relief of heartburn & are adjunctive or for occasional GERD

avoid Mg-containing in renal failure

Question 2

What are the names of the antacids mentioned?

Answer 2

tums, rolaids, maalox, gaviscon

Question 3

What is the purpose of H2 receptor antagonists?

Answer 3

mild esophagitis in GERD (heals 70-80%) & is effective for symptomatic gastritis

Question 4

What is the MOA of H2 receptor antagonists?

Answer 4

Blocks the effect of histamine on gastric cells –>

1. decreased acid production
2. eliminates ACh & gastrin on acid production

Question 5

What is the brand name of Famotidine & what class is it in?

Answer 5

H2 blocker: Pepcid

Question 6

What is the brand name of Ranatadine & what class is it in?

Answer 6

H2 blocker: Zantac

Question 7

What is the brand name of Cimetidine & what class is it in?

Answer 7

H2 blocker: Tagamet

Question 8

What effect do H2 blockers have in CKD & pregnancy?

Answer 8

Dose adjusted in CKD & not used in ESRD

Safe in pregnancy & lactation

Question 9

What are the 2 main side effects of H2 blockers?

Answer 9

Tachyphylaxis
B-12 deficiency
HoTN, QT prolongation (with rapid infusion)
confusion/hallucinations (in elderly)

Question 10

What is the purpose of PPIs?

Answer 10

most powerful tx for GERD

Question 11

What is the MOA of PPIs?

Answer 11

binds to H/K ATPase pump in gastric parietal cells –> acid secretion blockage (take in AM- need acid to work)

Question 12

What is the brand name of Omeprazole and what class is it in?

Answer 12

PPI: Prolisec

Question 13

What is the brand name of Lansoprazole & what is the class?

Answer 13

PPI: Prevacid

Question 14

What is the brand name of Dexlansoprazole & what is the class?

Answer 14

PPI: Dexilant

Question 15

What is the brand name of Rabeprazole & what is the class?

Answer 15

PPI: Aciphex

Question 16

What is the brand name of Pantoprazole & what is the class?

Answer 16

PPI: Protonix

Question 17

What is the brand name (2) of Esomeprazole/Na Bicarb & what is the class?

Answer 17

PPI: Nexium/Zegerid

Question 18

What is the effect of PPIs in CKD & pregnancy?

Answer 18

Increased risk of CKD (but no need to dose adjust)

Safe in pregnancy

Question 19

What is the brand name of Carafate?

Answer 19

Sulcrafate

Question 20

What is the MOA of Carafate?

Answer 20

ulcer-adherent & protects the ulcer; stimulates gastric angiogenesis & formation of granulation tissue

Question 21

What is the use of Carafate?

Answer 21

MC as an add-on tx for patients not well enough controlled on H2 blockers or PPIs

Question 22

What is the brand name (2) of Bismuth?

Answer 22

Peptobismol, Kaopectate

Question 23

What is the MOA of Bismuth?

Answer 23

Suppresses H. pylori, binds to ulcer & promotes healing

Question 24

What is the brand name of Misoprostol?

Answer 24

Cytotec

Question 25

What is the MOA of Misoprostol?

Answer 25

analogue of prostaglandin E which inhibits acid secretion & enhances mucosal defense

Question 26

What is the indication for Misoprostol?

Answer 26

used only to prevent NSAID induced gastritis

Question 27

What is the effect of Misoprostol on pregnancy?

Answer 27

contraindicated in women of childbearing age not on contraception

Question 28

What is the algorithm for GERD/PUD/Gastritis?

Answer 28

H2 or PPI (can't use antacids routinely w/PPIs) & continue tx for 4-8w If no improvement, increase PPI to bid or add adjunctive tx If no improvement, endoscopy If refectory, Nissen fundoplication (for GERD)

Question 29

What is the treatment of PUD/Gastritis?

Answer 29

eradicate H. pylori, PPI or H2 for 4w for duodenal ulcer, & 8w for gastric ulcer - avoid NSAIDs, if pt must, give PPI or Misoprostol (Cytotec)

Question 30

What is the brand name of Ondansetron and what class is it in?

Answer 30

SSRAs (5-H3T Receptor Antagonists): Zofran prn (not a scheduled med)

Question 31

What is the indication of SSRAs/5H3T?

Answer 31

most useful class in chemo & postop n/v

Question 32

What is the important AE of SSRAs/5H3T?

Answer 32

QT prolongation, torsades

Question 33

What is the brand name of Aprepitant and what is the class?

Answer 33

Neurokinin Receptor Anatagonist: Emend | Fosaprepitant [IV]

Question 34

What is the indication of Aprepitant?

Answer 34

prevention of chemo emesis

Question 35

What is the brand name of Diphenyldramine & what class is it in?

Answer 35

Antihistamine: Benadryl

Question 36

What is the brand name of Hydroxyzine & what is the class?

Answer 36

Antihistamine: Vistaril

Question 37

What is the brand name of Promethazine & what is the class?

Answer 37

Antihistamine: Phenagran

Question 38

What are the AEs of Benadryl?

Answer 38

CNS depression, sedation, anticholinergic SEs, exraparamidal

Question 39

What are the AEs of Vistaril?

Answer 39

involuntary movement, respiratory depression, anticholinergics

Question 40

What is are the AEs of Phenegran?

Answer 40

anticholinergics, sedation, extrapyramidal symptoms, NMS, tissue injury

Question 41

What is the brand name of Scopolamine & what class is it in?

Answer 41

Transderm Scop (patch)

Question 42

What is the indication of Scopolamine?

Answer 42

MC for motion sickness | Adjunct chemo N or prolonged mild N

Question 43

What are the AEs of Scopolamine?

Answer 43

in old: confusion & anticholinergic effects

Question 44

What is the brand name of Prochlorperazine and what class is it in?

Answer 44

Dopamine Receptor Antagonist: Compazine

Question 45

What is the brand name of Chlopromazine and what class is it in?

Answer 45

Dopamine Receptor Antagonist- Phenothiazines: Thorazine

Question 46

What are the SEs of Dopamine Receptor Antagonists?

Answer 46

QT prolongation, potentiation of CNS depressants

Question 47

What is the brand name of Metoclopramide and what class is it in?

Answer 47

Dopamine Receptor Antagonist- Benzamides: Reglan

Question 48

What is the brand name of Dronaninol & what class is it in?

Answer 48

Cannaboid: Marinol

Question 49

What are the SEs of Marinol?

Answer 49

hallucinations, paranoia, euphoria, sedation, "highs"

Question 50

What is the indication of Marinol?

Answer 50

chemo n/v when other agents aren't effective

Question 51

What are the indications of glucocorticoids?

Answer 51

chemo-induced