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GI 1-2
BDK
| Pharmacologic Category | Generic Name | Brand Name | Classification | Common Indications | Essential Knowledge |
|---|---|---|---|---|---|
| Gastrointestinal protectant | sulcrafate (PO) | Carafate | duodenal ulcers | Key Side Effects: constipation, bezoar formation Other Notes: take on an empty stomach; many drug interactions due to reducing absorption of other drugs | |
| Proton pump inhibitor (PPI) | dexlansoprazole (PO) esomeprazole (PO, IV) lansoprazole (PO) omeprazole (PO) pantoprazole (PO, IV) | Dexilant Nexium Prevacid Prilosec Protonix | PO nexium, prevacid and prilosec are OTC | GERD, PUD, erosive esophagitis, SUP | Key Side Effects: headaches, abdominal pain, nausea, diarrhea, bone fracture, vitamin B12 deficiency, hypomagnesemia, increased risk of Clostridioides difficile associated diarrhea (CDAD) |
| Antidiarrheal | diphenoxylate and atropine (PO) | Lomotil | CS-V | Diarrhea | Key Side Effects: nausea, confusion, drowsiness, dizziness, xerostomia, tachycardia, urinary retention Other notes: do not use in diarrhea associated with enterotoxin- |
| Histamine (H1) antagonist | meclizine (PO) | Bonine | OTC | Motion sickness, vertigo | Key Side Effects: drowsiness, dry mouth, blurry vision |
| Histamine (H1) antagonist | promethazine (PO, IM, IV, PR) | Phenergan | Motion sickness, nausea, vomiting | Key Side Effects: drowsiness, dry mouth, blurred vision, QTc prolongation, EPS US Boxed Warnings: potential for fatal respiratory depression in patients < 2 years old; injection can cause peripheral extravasation (preferred parenteral route is IM) | |
| Selective serotonin in (5-HT3) antagonist | ondansetron (PO, IV) | Zofran | Nausea, vomiting | Key Side Effects: headache, fatigue, constipation, QTc prolongation | |
| Dopamine (D2) antagonist | metoclopramide (PO, IV) | Reglan | Gastroparesis, GERD, nausea, vomiting | Key Side Effects: drowsiness, dystonia, akathisia, EPS, QTc prolongation, diarrrhea, hyperprolactinemia, US Boxed Warnings: may cause tardive dyskinesia, do not use >12 weeks, Other notes: CI with GI obstruction, perforation, or hemorrhage | |
| Histamine (H2) antagonist | famotidine (PO, IV) | Pepcid, Zantac 360 | PO OTC | GERD, erosive esophagitis, SUP | Key Side Effects: headache, constipation, diarrhea, mental status changes |
| Corticosteroid | hydrocortisone (PO, IV, topical) | Topical: Cortaid IV: Solu-Cortef | Topical: OTC | Topical: Inflammation, rash PO/IV: Acute illness, adrenal insufficiency | Key Side Effects: hyperglycemia, increased appetite with weight gain, depression, irritability, anxiety, restlessness, insomnia, osteoporosis (chronic use), Cushing's syndrome (chronic use) Other Notes: risk of adrenal suppression with prolonged use |
| Corticosteroid | prednisone (PO) | Deltasone, Rayos | Inflammatory diseases, COPD exacerbation, asthma exacerbation, acute gout | Key Side Effects: hyperglycemia, increased appetite with weight gain, depression, irritability, anxiety, restlessness, insomnia, osteoporosis (chronic use), Cushing's syndrome (chronic use) Other Notes: risk of adrenal suppression with prolonged use | |
| Corticosteroid | prednisolone (PO | Orapred | Inflammatory diseases, COPD exacerbation, asthma exacerbation, acute gout | Key Side Effects: hyperglycemia, increased appetite with weight gain, depression, irritability, anxiety, restlessness, insomnia, osteoporosis (chronic use), Cushing's syndrome (chronic use) Other Notes: risk of adrenal suppression with prolonged use | |
| Corticosteroid | methylprednisolone (PO, IM, IV) | Medrol, Solu-Medrol | Inflammatory diseases, COPD exacerbation, asthma exacerbation, acute gout | Key Side Effects: hyperglycemia, increased appetite with weight gain, depression, irritability, anxiety, restlessness, insomnia, osteoporosis (chronic use), Cushing's syndrome (chronic use) Other Notes: risk of adrenal suppression with prolonged use | |
| Corticosteroid | dexamethasone (PO, IV) | DexPak, DoubleDex | Inflammatory diseases, cerebral edema, CINV | Key Side Effects: hyperglycemia, increased appetite with weight gain, depression, irritability, anxiety, restlessness, insomnia, osteoporosis (chronic use), Cushing's syndrome (chronic use) Other Notes: risk of adrenal suppression with prolonged use | |
| Stool softener | docusate (PO) | Colace | OTC | Prevent straining during defecation | Other Notes: do not use with mineral oil |
| Stimulant laxative | senna (PO) | Ex-Lax, Senokot | OTC | Constipation | Key Side Effects: abdominal cramping, electrolyte imbalance |
| Osmotic laxative | Lactulose (PO) | Enulose, Constulose | Constipation, hepatic encephalopathy | Key Side Effects: abdominal cramps, abdominal distention, diarrhea, flatulence | |
| Osmotic laxative | polyethylene glycol 3350 (PO) | Miralax | OTC | Constipation | Key Side Effects: abdominal cramping, electrolyte imbalance Other Notes: CI with bowel obstruction |
| Guanylate cyclase C agonist | linaclotide (PO) | Linzess | IBS-C, opioid-induced constipation | Key Side Effects: diarrhea, abdominal pain, US Boxed Warnings: do not use in patients <2 years of age (risk of death due to dehydration), Other Notes: mechanical gastrointestinal obstruction | |
| Anticholinergic; Antispasmodic | dicyclomine (PO) | Bentyl | IBS | Key Side Effects: drowsiness, blurred vision, dizziness, xerostomia, constipation Other Notes: CI in gastrointestinal obstruction, reflux esophagitis, acute hemorrhage with cardiac instability, obstructive uropathy, glaucoma |