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Digestion Meds
| Question | Answer |
|---|---|
| Histamine 2 Blockers | Cimetidine Famotidine |
| Histamine 2 Blocker Therapeutic Uses | -Gastric/Duodenal Ulcer -GERD -Zollinger-Ellison Syndrome (hypersecretion) |
| Histamine 2 Blocker Side Effects | -CNS effects (hallucinations, confusion, restlessness, lethargy, dizziness) -Decreased gastric acidity (can lead to bacterial colonization promotion ie: pneumonia, h. pylori) -Reduce dosage for renal impairment |
| Antibiotics | Penicillin Amoxicillin Clarithromycin Prokinetic Agents Metronidazole Tetracycline |
| Antibiotic Side Effects | -Most common allergy -Renal impairment (monitor BUN & creatinine) -Prolonged QT -Ototoxicity -Risk of superinfection -GI symptoms -Neurotoxicity, seizure , can't mix with alcohol (metronidazole) -Brown/yellow teeth, photosensitivity (tetracycline) |
| Proton Pump Inhibitors | Omeprazole Pantoprazole Lansoprazole Esomeprazole |
| Proton Pump Inhibitor Therapeutic Uses | -Blocks acid production -Reduces gastric acid secretion -Short term (4-6) therapy for gastric & duodenal ulcer, GERD -Long term therapy for hypersecretory conditions -Hiatal hernia |
| Proton Pump Inhibitor Side Effects | -Risk for aspiration can lead to pneumonia -Risk for osteoporosis (decreased calcium absorption (exercise, take vitamin D and calcium) -Take in lowest dose -Taper don't stop abruptly -Hypomagnesemia (risk for seizures) -C. diff |
| Mucosal Protectant | Sucralfate |
| Mucosal Protectant Therapeutic Uses | -Antiulcer drug -Protective barrier -"Sticks" to the ulcer for 6 hrs -Neutralize, reduce gastric acid -Give on empty stomach 1 hour before meals |
| Mucosal Protectant Side Effects | -Constipation -Antacids may decrease binding to GI mucosa impairing effectiveness (separate dosages by 30 min) -Interferes with absorption of Warfarin and Digoxin (separate dosages by 2 hours |
| Antacids | Aluminum Hydroxide Magnesium Hydroxide Calcium Carbonate |
| Antacids Therapeutic Use | -Neutralize or reduce acidity of gastric acid -Peptic or stress induced ulcer -GERD -Hiatal hernia |
| Antacid Complications/Contraindications | -Aluminum: constipation, hypophosphatemia, decrease warfarin and digoxin effects -Calcium: constipation, hypercalcemia -Magnesium: diarrhea, hypermagnesemia -Sodium: fluid retention, alkalosis (don't give to pt with CHF or renal insufficiencies) |
| Prostaglandin E Analog | Misoprostol |
| Prostaglandin E Analog Therapeutic Uses | -Decreases acid secretion -Increases bicarbonate secretions, protective mucus -Ulcers caused from long term NSAID use |
| Prostaglandin E Analog Side Effects/Contraindications | -Diarrhea -Dysmenorrhea -Spotting -Pregnancy category X |
| Antiemetics: Serotonin Antagonist | Ondansetron |
| Antiemetics: Serotonin Antagonist Side Effects | -Headache -Sedation -Dizziness -Diarrhea -Prolonged QT |
| Antiemetics: Dopamine Antagonists | Prochlorperazine Metoclopramide (also used for gastroparesis) Promethazine |
| Antiemetics: Dopamine Antagonist Side Effects | -EPS symptoms (lip smacking, restlessness, drowsiness, facial spasms) -Give diphenhydramine before giving to minimize SE -Hypotension |
| Antiemetics: Anticholinergics | Scopolamine |
| Antiemetics: Anticholinergic Side Effects | -Dry eyes -Dry mouth -Urinary retention -Inability to sweat -Changes ocular pressure (don't give to glaucoma pts) |
| Antiemetics: Antihistamine | Dimenhydrinate Hydroxyzine |
| Antiemetics: Antihistamine Side Effects | -Histamine 1 -Drowsiness -Dry mouth -Photosensitivity -Do NOT combine with alcohol severe vomiting |
| Antiemetics: Benzodiazepine | Lorazepam |
| Antiemetics: Benzodiazepine Side Effects | -Increased sedation -Decreased respirations -Risk for both above increases if combined with any other meds |
| Antiemetics: Cannabinoids | Dronabinol |
| Antiemetics: Cannabinoids Side Effects | -Avoid use with pts that have history or drug use or mental health issues -HTN -Tachycardia |
| Laxatives | Psyllium (bulk forming; promotes mass creation) Docusate Na (surfactant; pulls water to soften stool) Bisacodyl (stimulant; triggers intestines to contract and push out) Senna (stimulant) Magnesium hydroxide (osmotic; pulls water to soften) |
| Laxative Complications/Contraindications | -GI irritation -Rectal burning (proctitis) -Toxic magnesium levels -Sodium absorption & fluid retention -Dehydration -Obstruction (bulk forming) -Fecal impaction -Bulk forming only one ok for ulcerative colitis |
| Antidiarrheals | Diphenoxylate + Atropine Loperamide |
| Antidiarrheal Side Effects | -Slows things down in the GI system -High doses can cause CNS symptoms -Don't give if have severe electrolyte imbalance -Contraindicated in megacolon with history of inflammatory bowel disorders |
| 5HT3 Antagonist | Alosetron |
| 5HT3 Antagonist Therapeutic Uses | -IBS-D lasting greater than 6 months -Resistance to other medications -N/V |
| 5HT3 Antagonist Complications/Contraindications | -Constipation -Chronic constipation -Crohn's disease -Bowel obstruction -Toxic colon |
| IBS-C | Lubiprostone |
| IBS-C Uses | -Nausea -Diarrhea |
| IBS-C Complications | -Do not use with patient that has history of bowel obstructions -Monitor stool frequency |
| Inflammatory Bowel | Sulfasalazine Mesalamine (5-aminosalicylates) Hydrocortisone (glucocorticoids) Azathioprine (immunosuppressants) Infliximab (immunomodulator) Metronidazole (antibiotic) |
| Inflammatory Bowel Therapeutic Uses | -Crohn's disease -Ulcerative colitis |
| Inflammatory Bowel Med Complication/Contraindications | -Use cautiously with blood disorders (anemia), monitor CMC -5-aminosalicylates contraindicated sensitivity to Sulfonamides, thiazide diuretics -Administer with food or after meal -1200 to 1500 mL of daily fluid -Do not crush enteric coated capsules |
| Probiotics | -Used to treat manifestations of IBS, ulcerative colitis, C diff -Can cause flatulence and bloating -If antibiotics or antifungals are used concurrently, administer 2 hours apart |
Created by:
NikkiLeigh83
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