facts - gi part2

What does PEG stand for?

Polyethylene glycol

Laxatives in this module (5)

GoLYTELY, MiraLAX (PEG 3350), bisacodyl (Dulcolax), lactulose (Enulose), linaclotide (Linzess)

Osmotic laxatives (3)

PEG + electrolytes (GoLYTELY), PEG 3350 (MiraLAX), lactulose (Enulose)

Stimulant laxative (1)

bisacodyl (Dulcolax)

Stool softener (1)

docusate (Colace)

Antiemetics, anti-nausea (5)

ondansetron (Zofran), meclizine (Antivert), prochlorperazine (Compazine), promethazine (Phenergan), metoclopramide (Reglan)

D2 antagonists in this module (3)

prochlorperazine (Compazine), promethazine (Phenergan), metoclopramide (Reglan)

Antispasmodic (1)

dicyclomine (Bentyl)

Probiotic (1)

Lactobacillus (Culturelle)

Somatostatin analog (1)

octreotide (Sandostatin)

Suffix -setron means

5-HT3 antagonist antiemetic

Bowel prep before colonoscopy (1)

PEG + electrolytes (GoLYTELY)

Laxative that also lowers ammonia in liver disease (1)

lactulose (Enulose)

Drug for IBS with constipation (1)

linaclotide (Linzess)

Drug for IBS cramping (1)

dicyclomine (Bentyl)

Antiemetic for chemo and post-op nausea (1)

ondansetron (Zofran)

Antiemetic for motion sickness and vertigo (1)

meclizine (Antivert, Bonine)

Drug for nausea AND gastroparesis (1)

metoclopramide (Reglan)

Antiemetic also for psychotic agitation (1)

prochlorperazine (Compazine)

Drug for variceal bleeding (1)

octreotide (Sandostatin)

OTC drugs in this module (5)

PEG 3350 (MiraLAX), bisacodyl (Dulcolax), docusate (Colace), meclizine (Bonine), Lactobacillus (Culturelle)

What does IBS-C mean?

Irritable bowel syndrome with constipation

What does N/V mean?

Nausea and vomiting

Osmotic laxative mechanism

Draws water into the bowel

Stimulant laxative mechanism

Increases peristalsis (gut movement)

Stool softener mechanism

Lets water mix into stool for easier passage

Ondansetron mechanism

Blocks 5-HT3 serotonin receptors

Metoclopramide extra effect

Speeds stomach emptying (prokinetic)

Dicyclomine mechanism

Anticholinergic, relaxes gut muscle

Common laxative side effects (2)

Bloating, diarrhea

Common D2 blocker and H1 side effect

Sedation

Common anticholinergic side effects (2)

Dry mouth, blurred vision

Common probiotic side effect

Mild gas

Serious laxative risk

Severe dehydration and electrolyte shifts

Serious D2 antagonist risk

Tardive dyskinesia

Metoclopramide boxed warning

Tardive dyskinesia, avoid use over 12 weeks

Serious ondansetron risks (2)

QT prolongation, serotonin syndrome

Serious octreotide risks (2)

Slow heart rhythms, gallstones

Promethazine IV risk

Severe tissue injury and gangrene

Promethazine in children

Contraindicated under 2 years (fatal respiratory depression)

QT drugs + ondansetron, prochlorperazine, promethazine, metoclopramide

Added QT risk

Serotonergic drugs + ondansetron

Serotonin syndrome

Laxative and stool softener contraindication

Bowel obstruction

Who should avoid live probiotics?

Severely immunosuppressed patients (bloodstream infection risk)

Ondansetron ODT means

Orally disintegrating tablet, dissolves on tongue

Look-alike: Zofran vs Zantac

Zofran = ondansetron (nausea). Zantac = ranitidine (old H2 blocker)

Look-alike: Reglan vs Regonol

Reglan = metoclopramide. Regonol = pyridostigmine (myasthenia gravis)

Look-alike: Colace vs Cozaar

Colace = docusate (stool softener). Cozaar = losartan (ARB)

Look-alike: Phenergan vs Phenobarbital

Phenergan = promethazine (nausea). Phenobarbital = barbiturate (seizures)

Look-alike: Dulcolax vs Dulcolax Stool Softener

Dulcolax tablets = bisacodyl (stimulant). Stool softener version = docusate