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GI E&M
| Answer | Hint |
|---|---|
| Antacids | decrease gastric acid |
| Antacids | do not protect mucosal linings |
| Antacids | for immed relief of HB |
| Antacids | safe in preg |
| antacids | take on empty stomach |
| Antacids | watch sodium,alum.ca,mg content |
| hypophosphatemia | see with prolonged alum use |
| hypermg | see with RI |
| promotility drugs | only if unresponsive to others |
| antacid duration | 2 hrs |
| Mg antacids | see diarh. |
| Na antacids | watch w/chf/HTN |
| Ca antacids | watch for renal stones |
| Na salts (alka seltzer) | most adverse effects) |
| MOM | adverse effect w/renal,geriatrics,kids <12 |
| PPI's | inhibit acid pump |
| Nsaid ulcer | MISOPROSTOL (cytotec) |
| Tagemet | highest interactions |
| H2 blockers | HS dose optimal |
| H2 blockers | all safe efficacy |
| PPI | QD dosing improves compliance |
| Geriat. | 1/2 dose better w/h2 blockers |
| Gero | No dose adj w/PPI |
| H2 blockers | cross placenta, ok after 1st trimester |
| Prilosec | Cat C |
| Axid | less drug interactions of H2 blockers |
| Prilosec | Category C |
| Protonix | less drug interactions |
| Cytotec | Cat X |
| PPI | best to take AC |
| laxatives and peds | no enemas,mg,phos |
| preg and laxatives | bulk or softeners preffered |
| ST constipation mild | bulks or softeners |
| ST severe constipation | stimulants,saline,enemas |
| high constipation | both stimulant and salines |
| LT constipation | continue x 1 week and reeval |
| bulk lax | increases weight of stool and stretches wall of colon leading to increased peristalisis |
| bulk lax | 1st line tx for mild ST constipation |
| bulk lax - psyllium | decreases serum cholesterol |
| bulk lax - fibercon | ck for hyperK |
| stool softeners | lowers surface tension allowing fecal mass to be penetrated by fluids |
| mineral oil | no longer safe |
| Caster oil | induces labor |
| osmotic lax | causes H2O to move from tissue into bowel, increases bulk and peristalisis |
| osmotic lax | requires rx |
| osmotic lax | good for bowel cleansing |
| osmotic lax ex | sorbitol, lactulose, miralax, glycerin |
| stimulant lax | most potent |
| stimulant lax | direct action on intes mucosa or nerve plexis |
| stim lax | dont take w/in 2 hrs of other meds |
| stim lax ex | biscodyl, MOM, cacara, senna |
| saline lax | attract and retain H2O in bowel, increaSES pressure, osmotic effect and induces cintraction of colon |
| saline lax | elect imbal in preg |
| most potent saline lax | mg citrate |
| enemas | colonic distension and lavage |
| fleets enemas | contrain. in renal |
| Opiod antidiar. | safe and effective |
| lomotil | opiod antidiar., schedule IV |
| lomotil | dont give w/downs r/t anticholinergic effects |
| lomotil | if given w/MAO > HTN crises |
| Imodium | long acting, and more potent than lomotil |
| Paregoric (antidia.) | opium component, sched III |
| absorbants (antidiar) ex pepto | ok for infections ( bind to bacteria and toxins) |
| pepto | contrain. if sens. to salycylatates, |
| pepto | high risk tox if given w asa |
| Kaopectate (absorb. antidiar) | not good for renal r/t mg and phos) |
| antiemetics (antidopaminergics) eg:thorazine, compazine, phenergan | effective in drug induces emesis |
| "zines" antiemetics | EPS SE, sedation, htpotension |
| Prokinetic antiemetic ex: Reglan | prevents stim of CTZ, good for iv use w/chemo |
| Anticholinergic antiemetics ex antihistamines) | supresses hyperstim of labyt. function |
| antihis. antiemetics | use before activity |
| scopalamine | direct action of VC |
| scopalamine | rapid plasma levels, and relief for 3 days |
| serotonin 5-HT3 rec. antagonists ex: zofran | stop for rash (hypersens rare, but serious) |
| zofran OD | blindness (short episodes) |
| IBS tx | bulk lax first |
| IBS meds | heat prostration |
| bentyl for IBS | cat B |
| levsin for IBS | cat C, 1/2 dose gero, ok for infant colic |
| Zelnorm for IBS | cat B, good if prim. prob is constipation, take on empty stomach, 98%protein bound |
| GI stim/prokinetic ex reglan | potential for EPS, confusion, depression with suicidal ideation |
| Prostaglandin ex: cytotec | use w/NSAID to < GI SE |
| cytotec | take with food, dont give w/antacids, increase dose slowly to avoid diar., CAT X!! |
| UC tx (sulfasalazine/mesalazine) | dont use if ASA sens, renal imp, sulfite sens., Cat B, OD looks like asa tox, do not take with milk |
| simethicone | good for newborns |
| gall ston solubizing agents ex:ursodiol | dissolves noncalcified gall stones, must have functioning GB, cont. 3 mo after dissolved. ok to continue even if some progress, oral contrac, estrogents counteract this drug |
| GB drugs | monitor LFT |
Created by:
keoughrn
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