NAPLEX GI (GERD, PUD, constipation, diarrhea, motion sickness)

Tums

calcium carbonate

Mylanta Supreme

calcium carbonate + magnesium

Maalox

calcium carbonate + simethicone

Milk of Magnesia

magnesium hydroxide

Mylanta Maximum Strength

magnesium hydroxide + aluminum + simethicone

Alka-Seltzer

sodium bicarbonate + asa + citric acid

Pepcid

famotidine

Zantac

famotidine

Tagamet

cimetidine

Dexilant

dexlansoprazole

Nexium

esomeprazole

Prevacid

lansoprazole

Prilosec

omeprazole

Protonix

pantoprazole

Reglan

metoclopramide

Reglan drug class

dopamine antagonist

Carafate indication

ulcers

Matamucil

psyllium

FiberCon

calcium polycarbophil

Citrucel

methylcellulose

Benefiber

wheat dextrin

Fleet Enema

sodium phosphate

Ex-Lax

senna

Senna S, Senokot S

senna + docusate

Dulcolax

bisacodyl

Colace

docusate

Linzess

linacolide

Linzess drug class

guanylate cyclase C agonist

Amitiza drug class

chloride channel activator

Entereg

alvimopan

Alvimopan drug class

PAMORA

Colyte

PEG electrolyte solution

GoLytely

PEG electrolyte solution

OsmoPrep

sodium phosphate

Suprep Bowel Prep Kit

sodium sulfate + potassium sulfate + magnesium sulfate

Colyte, GoLytely indication

laxative used for whole bowel irritation

OsmoPrep

laxative used for whole bowel irritation

Suprep Bowel Prep Kit

laxative used for whole bowel irritation

Pepto-Bismol

bismuth subsalicylate

Pepto-Bismol drug class

antidiarrhea

Imodium

loperamide

Imodium drug class

antidiarrheal

Lomotil

diphenoxylate + atropine

Lomotil drug class

antidiarrheal

Bentyl

dicyclomine

Bentyl drug class

antispasmodic for diarrhea

Entocort EC, Uceris

budesonide for IBS

Pentasa

mesalamine capsule

Rowasa

mesalamine enema

Canasa

mesalamine suppository

Tysabri

natalizumab

Entyvio

vedolizumab

Natalizumab drug class

integrin receptor antagonists for IBS

Vedolizumab drug class

integrin receptor antagonists for IBS

Transderm Scop

scopolamine

Dramamine

dimenhydrinate

Dramamine Less Drowsy

meclizine

Pharmacists should refer patients to see further evaluation if they do not respond to lifestyle modifications and/or ____weeks of self-treatment with OTC products, or if alarm sx are present (odynophagia (painful swallowing), dysphagia, frequent N/V, hematemesis, black or blood stools, unintentional weight loss)

2

Infrequent heartburn (< 2 times/week) can be treated with OTC _________ as needed

antacids, H2RAs

Initial drug treatment for GERD: PPI once daily for ____ weeks, can increase to BID if parital response or if nocturnal sx are present. If symptoms return after _____ weeks, start maintenance therapy

8

1st line maintenance treatment for GERD, give at the lowest effective dose

PPI

Alternative maintenance treatment for GERD: _____, if there is no erosive esophagitis and it relieves sx

H2RAs

Which meds are not recommended for maintenance therapy for GERD?

metoclopramide, sucralfate

_____-containing antacids may be preferred in pregnancy

calcium

For antacids, dosing varies by product; may require administration ____ times per day

4-6

Which type of antacids can cause constipation?

calcium, aluminum

Which type of antacids can cause loose stools?

magnesium

______ neutralize gastric acid, which increases gastric pH. Since they do not require systemic absorption, they provide relief within minutes, but the duration of relief is short (30-60 mins)

antacids

_____ reversibly inhibit H2 receptors on gastric parietal cells, which decreases gastric acid secretion

H2RAs

Which meds should have its dose decreased when CrCl < 60?

famotidine, metoclopramide

Which H2RA can cause gynecomastia and impotence at high doses?

cimetidine

Which H2RA is typically avoided due to drug interactions and side effects?

cimetidine

Which med can cause confusion (usually reversible; risk factors: older adult, severely ill, renal impairment)?

H2RA

Which H2RA can come in an injection?

famotidine

_____ irreversibly inhibit the gastric H+/K+-ATPase pump (proton pump) in parietal cells, which blocks gastric acid secretion

PPI

Which PPI can come in an injection (IV)?

esomeprazole, pantoprazole

Which PPIs should not be used with clopidogrel? (can diminish the effects of clopidogrel)

esomeprazole, pantoprazole

Warnings for PPIs?

C. diff, hypomagnesemia, vitamin B12 deficiency, osteoporosis

Which PPIs can be taken without regard to meals?

dexlansoprazole, pantoprazole tablet, rabeprazole tablet

Which PPIs should be taken before breakfast?

esomeprazole, lansoprazole, omeprazole

Which PPI should be taken at least 60 mins before breakfast?

esomeprazole

Which PPI should be taken 30 mins before a meal?

pantoprazole

Which PPI comes in ODT formulation?

lansoprazole, omeprazole

______ is most commonly used for patients with coexisting gastroparesis

metoclopramide

Which med has a BW for tardive dyskinesia and has warnings for EPS (including acute dystonia, parkinsonian-like sx, and should be avoided in patients with Parkinson disease?

metoclopramide

Which H2RA is an inhibitor CYP450 enzymes?

cimetidine

All PPIs inhibit CYP____, most are weak inhibitors, but Omeprazole and Esomeprazole are moderate inhibitors and can decrease the effectiveness of clopidogrel (prodrug).

2C19

With ______ ulcers, pain is typically worse 2-3 hours after eating (when the stomch is empty)

duodenal

With ______ ulcers, eating generally worsens the pain

gastric

Duodenal ulcers are usually caused by ______

H. pylori

Gastric ulcers are usually caused by _____

NSAIDs

What is the diagnostic test for H. pylori that detects gas (CO2) produced by the bacteria

urea breath test (UBT)

To avoid false-negatives when testing for H. pylori, _____ should be discontinued 2 weeks prior to these tests, and _______ should be discontinued 4 weeks prior

PPIs, bismuth, antibiotics

Treatment duration for H. pylori eradication regimens is ______ days

14

Do NOT use __________ in patients with alcohol use

metronidazole

What is the preferred 1st-line regimen for PUD?

bismuth quadruple therapy

What is the Bismuth quadruple therapy?

Bismuth Subsalicylate 300 mg QID + Flagyl 500 mg TID or QID + Tetracycline 500 mg QID + PPI BID

What are the alternative treament regimens for PUD in patients without a penicillin allergy?

rifabutin triple therapy, potassium-competitive acid blocker dual therapy

What is the Rifabutin Triple Therapy?

Amoxicillin 1000 mg TID + Rifabutin 50 mg TID + Omeprazole 40 mg TID

What is the potassium-competitive acid blocker dual therapy?

Amoxicillin 1000 mg TID + Vonoprazan 20 mg BID