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GI System

Petic ulcers, GI disorders, vitmamins/minerals

amoxicillin (Amoxil) bismuth (Pepto-Bismol) clarithromyocin (Biaxin) metronidazole (Flagyl) tetracycline (Achromycin V, Sumycin) Antibiotics
ranitidine (Zantac) cimetidine (Tagamet) famotidine (Pepcid) nizatidine (Axid) H2 Antagonists
SE- decreased libido and impotence CNS effects-lethargy, depression, confusion Tagamet
Use caution with patients that have high risk for pneumonia
H2 antagonists- concurrent use of this med can decrease absorption antacids
Which H2 antagonist inhibits metabolizing enzymes? cimetidine
omeprazole (Prilosec) pantoprazole (Protonix) Proton Pump Inhibitor
Levels of digoxin, phenytoin, warfarin may be increased when taking omeprazole
When to take PPIs once a day before AM meal
Mucosal Protectant sucralfate (Carafate)
sucralfate-to prevent constipation advise patients to increase dietary fiber and drink at least 1500 mL/day
When to take sucralfate 4x day, 1hr before meals and at bedtime
Interferes with absorption and should not take within 30 mins of sucralfate antacids
aluminum hydroxide (Amphojel) aluminum carbonate (Basaljel) magnesium hydroxide (Milk of Magnesia) sodium bicarbonate calcium carbonate (Tums) Antacids
Aluminum and calcium cause constipation
Magnesium cause diarrhea
Amphojel can lead to hypophosphatemia and hypomagnesemia
Binds to warfarin and tetracycline and interfere with absorption. Take 1 hr apart aluminum
How to take antacids chew tablets thoroughly drink 8oz of water or milk
Take all meds one hour before taking antacids
Prostaglandin misoprostol (Cytotec)
Used to prevent gastric ulcers misoprostol
Using magnesium antacids and misoprostol can increase diarrhea
When to take misoprostol meals and bedtime
Managing peptic ulcer disease Avoid eating too many meals Avoid excessive intake of mile and cream Low dose aspirin is permitted Reduce stress wherever possible Avoid smoking
dexamethasone (Decadron) aprepitant (Emend) ondansetron (Zofran) gransisetron (Kytril) prochlorperazine, metoclopramide (Reglan) promethazine (Phenergan) dronabinol (Mairnol) lorazepam (Ativan) Antiemetics
scopolamine dimenhydrinate (Dramamine) treats motion sickness
Increase appetite in patients who have AIDS dronabinol
SE of antiemetics Hypotension, anticholinergic effects, sedation
SE only with prochlorperazine Extrapyramidal symptoms- restlessness, anxiety, spasms of face and neck (RAS)
Tx of EPS anticholinergics
psyllium (Metamucil) docusate sodium (Colace) bisacodyl (Dulcolax) magnesium hydroxide (Milk of Magnesia) senna (Senokot) lactulose (Cephulac) Laxatives
Bulk-forming laxatives-softens fecal mass and increases bulk (like fiber) psyllium
Surfactant laxatives- lowers surface tension of the stool to allow water in docusate sodium
Stimulant laxatives- stimulates intestinal peristalsis bisacodyl
Osmotic laxatives- draw water into the intestine to increase mass of stool magnesium hydroxide
Side effects of laxatives GI irritation, rectal burning
SE of magnesium hydroxide magnesium toxicity
SE of sodium phosphate risk of sodium absorption and fluid retention
Laxative contraindications fecal impacation, bowel obstruction, nausea, cramping and abdominal pain
Interactions with bisacodyl Milk and antacids- take 1 hr apart
Take psyllium and docusate with glass of water
Time to take effect- laxatives oral-6-12 hrs rectal 15 mins
diphenoxylate plus atropine (Lomotil) loperamide (Immodium) paregoric Antidiarrheals
What should patients avoid when taking antidiarrheals? Caffeine-increase GI motility Alcohol- enhances CNS effects Plain water
Prokinetic agents metoclopramide (Reglan)
Which med blocks dopamine and seretonin receptors in the CTZ? metoclopramide
Side effects of metoclopramide sedation, EPS, diarrhea
What meds decrease effect of metoclopramide? Opiods and anticholinergics
IBS with Diarrhea alosetron (Lotronex)
How long does it take for alosetron to work? 1-4 weeks
IBS with constipation lubiprostone (Amitiza)
SE of lubiprostone diarrhea and nausea
Contraindicated for patients with hx of bowel obstruction, Crohns dz, ulcerative colitis, diverticulitis
When to take lubiprostone? BID
sulfasalazine (Azulfidine) mesalamine (Asacol, Rowasa) Olsalazine (Dipentum) 5-aminosalicylates
SE of 5-aminosalicylates blood disorders nausea, cramps, rash, arthalgia
Alter the absorption of sulfasalazine iron, antibiotics
Mesalamine decreases absorption of digoxin
Used to tx numerous GI disorders (ex. c.diff) Consist of bacteria normally found in digestive tract Probiotics
When to take probiotics 2hr after antibiotics
Created by: vescobar