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GI Tx
Gastroenterology
| Question | Answer |
|---|---|
| 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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