Pharm - GI drugs (3.1)

antacids

these are what drug class?

- magnesium hydroxide (Milk of Magnesia)

- aluminum hydroxide

- calcium carbonate (tums)

- sodium bicarbonate

tums

calcium carbonate brand name is ______

antacid MOA

MOA: neutralize stomach acid to decrease gut wall destruction

antacids TU

TU: peptic ulcer disease, GERD

antacids AE

AE:

magnesium - diarrhea

aluminum - constipation

tums - possible constipation, belching, gas

sodium bicarbonate - alkalosis

magnesium antacids

- rapid onset, long duration, potent antacid

- Side effect is diarrhea

aluminum antacids

- slow onset, long duration, weak antacid

- Side effect is constipation

antacids NI

NI: after taking this med, wait 1 hour before taking any other meds

H2 blockers

drugs ending in -tidine are what class of drug?

famotidine, cimetidine class

class: H2 receptor antagonist

famotidine MOA

MOA: decreases secretion of gastric parietal cells by blocking H2 receptors

famotidine TU

TU: peptic ulcers, GERD, heartburn/indigestion

Pepcid

famotidine brand name is _________

famotidine AE

AE: pneumonia, blocks androgen receptors, CNS

cimetidine DI

DI: with this H2 blocker specifically, it can inhibit hepatic metabolism

- antacids decrease the absorption of this drug

proton pump inhibitors (PPIs)

drugs ending in -prazole are what type of drugs?

omeprazole, pantoprazole class

class: PPIs

omeprazole, pantoprazole MOA

MOA: pro drug, irreversibly inhibits H+ K+ ATPase

omeprazole, pantoprazole TU

TU: peptic ulcers, GERD, Zollinger-Ellison (hypersecretion)

Omeprazole AE

AE: pneumonia, increased risk for C. diff, possible osteoporosis

Omeprazole NI

NI: take on empty stomach and then eat afterwards to get the most benefit; not recommended for pregnancy

pantoprazole

this PPI is specifically an IV drug for when someone is NPO but still needs the med

prilosec

ompreazole brand name is ____________

protonix

pantoprazole brand name is __________

sucralfate (Carafate) MOA

MOA: creates protective barrier against acid & pepsin

antiemetic drugs

- ondanestron (Zofran)

- promethazine (Pheneragan)

- metoclopramide (Reglan)

- dimenhydrinate (Dramamine)

ondanestron (Zofran) class

class: 5HT3 antagonist

- serotonin

ondanestron MOA

blocks serotonin receptors in CTZ

ondanestron TU

TU: preventing acute emesis (best to treat before emesis)

ondanestron AE

AE: D, headache, dizziness

promethazine, prochlorperazine class

class: dopamine antagonists

phenergan

promethazine brand name is ______

promethazine, prochlorperazine MOA

MOA: block dopamine receptors in CTZ

promethazine TU

TU: vomiting from chemotherapy, post op, opioids

promethazine AE

AE: anticholinergic effects, hypotension, sedation, extrapyramidal symptoms

metoclopramide (Reglan) class

Class: dopaminergic antagonist - prokinetic agents

metoclopramide MOA

MOA: blocks dopamine + serotonin in CTZ

metoclopramide TU

TU: N & V, diabetic gastroparesis

metoclopramide AE

AE: sedation, diarrhea

- CI: obsturction, perforation, or hemorrhage

Dimenhydrinate (Dramamine) MOA

MOA: "disconnects" input from vestibular system to vomiting center

Dimenhydrinate (Dramamine) AE

TU: motion sickness

AE: sedation, anticholinergic

- works best prophylactically

laxative contraindications

- acute, undiagnosed abdominal pain

- appendicitis

- acute surgical abdomen

- bowel obstruction, fecal impaction

Psyllium (Metamucil) class

class: bulk forming laxatives

Psyllium (Metamucil) MOA

MOA: swell with water to soften fecal matter & increase bulk to increase peristalsis

Psyllium (Metamucil) TU

TU: temporary treatment of constipation, could also help diarrhea tho

Psyllium (Metamucil) AE

AE: esophageal obstruction, intestinal impaction if lumen is narrow

- take with full glass of water

Docusate sodium (Colace) class

Class: lubricating laxatives

- "stool softeners" "detergent"

Docusate sodium (Colace) MOA

MOA: makes softer stool - makes it slippery

- give with a glass of water

bisacodyl (Dulcolax), senna (Senokot) class

class: stimulant laxatives

dulcolax, senna MOA

MOA: stimulate intestinal smooth muscle contraction

TU: constipation

dulcolax, senna AE

AE: abdominal cramps, widely used & abused

- work quickly, so be prepared!

polyethylene glycol (PEG, MiraLax) class

Class: osmotic laxatives

polyethylene glycol (PEG, MiraLax) MOA

MOA: poorly absorbed salts that draw water in lumen

TU: occasional constipation

polyethylene glycol (PEG, MiraLax) AE

AE: N, bloating, cramping, gas, diarrhea

- Works in 2 days; not absorbed, increases fecal mass

simethicone class

class: antiflatulent

simethicone MOA

MOA: changes surface tension of gas bubbles, allowing easier elimination of gas

- used for gas & bloating

imodium

what is the brand name for loperamide?

lomotil

what is the brand name for diphenoxylate + atropine

diphenoxylate + atropine, loperamide class

class: antidiarrheal

MOA: decreases motility

loperamide (imodium)

Structural analog of meperidine (Demerol), poorly absorbed

- used to treat diarrhea

levsin

brand name for hyoscyamine?

hyoscyamine class

Class: antimuscarinic/antispasmodics

hyoscyamine MOA

MOA: reduces smooth muscle cramps

hyoscyamine TU

TU: lithiasis

hyoscyamine AE

AE: constipation

CI: bowel obstruction, glaucoma, myasthenia gravis