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GI Tx

Gastroenterology

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