Gastroenterology
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| Gall bladder disease tx | zosyn (Pip-TZ) OR Unasyn (Am-SB) OR Timentin (TC-Clav) OR ertapenem
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| Severe diarrhea | Cipro OR Levaquin OR TMP-SMX-DS
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| Severe diarrhea: s/s = | >6 stools/day, >101F, tenesmus, blood, fecal WBC
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| Gastroenteritis: C. jejuni | Azithro
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| IBD tx options | 5-ASA; corticosteroids; 6MP/AZA; anti-TNF Ab
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| Abx for diarrhea 2/2: | Shigella, C. diff, extra-intestinal Salmonella, traveler’s diarrhea, cholera, amebiasis & giardiasis
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| UC tx | mild 5-ASA, prednisone; severe HD steroid, cyclosporine, infliximab, surg
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| CD tx | anti-inflam (5-ASA, steroids), cipro, azothioprine, MTX, infliximab
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| IBS tx: SSRI vs TCA | SSRA for IBS-C, TCA works for IBS-D
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| HCV mgmt | Interferon with ribavirin (CI in advanced liver dz, psych dz, poss renal, cardiac, DM retinopathy)
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| Hep B tx | acute: supportive; chronic: Entecavir and tenofovir firstline
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| Chemotherapy induced N/V (CINV) tx | Ondansetron (Zofran) (5-HT3 blockers)
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| Diverticulitis tx | IV Abx, fluids, NPO
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| H. pylori gastritis tx | 2 antibiotics & PPI
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| Traveler's diarrhea (ETEC) tx: | hydration & Cipro
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| pancreatic ca tx | whipple; stenting; chemo +/- XRT
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| Colon cancer (CRC) Tx of choice | Resection + lymph node staging; adjuvant CT +/- RT
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| V cholera tx | rehydrate & 1 dose Cipro; untx’d 50% mortality
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| Shigella Tx | Abx: TMP/SMX is TxOC; poss FQ/cipro; Amoxicillin is NOT EFFECTIVE
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| DO NOT use anti-motility agents in: | pts w/shigella, C diff, E coli O157 (inflammatory diarrhea)
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| Tx of choice for more severe infxs diarrhea: | FQ; TMP-SMX = 2nd-line tx; add azithro for Campy
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| H pylori Tx | Triple tx: (PPI + Amox + clarithro) OR (PPI + Flagyl + clarithro); Quadruple tx: PPI + bismuth + Flagyl + tetracycline
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| Gastric ca: Tx | Surgical resection (best chance for cure); Neoadjuvant CTx & XRT; Adjuvant CTx
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| Hep A tx | IVIG within 14d post exposure
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| Hepatic Encephalopathy tx | r/o infxn, correct lytes; lactulose; neomycin; rifaximin
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| Celiac dz Tx | GFD curative; if no improvement, consider alt dx (lymphoma, Giardia, panc insuff, lactose intolerance)
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| Whipple dz: tx = | prolonged antibiotic therapy
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| Severe salmonella gastroenteritis tx | TMP/SMX, amp, or Cipro; for severe, SCD, or bacteremia
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| Meds associated with constipation | NSAIDs, opiates, anticholinergics (TCAs, phenothiazine, antihistamine), CCBs, clonidine, iron
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| Meds associated with diarrhea | Antacids with Mg. Abx (clind, Sulfa, broad-spectrum). Colchicine. Reglan. Prostaglandins. Anti-neoplastics
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Created by:
Abarnard
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