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GI System
Petic ulcers, GI disorders, vitmamins/minerals
| Question | Answer |
|---|---|
| amoxicillin (Amoxil) bismuth (Pepto-Bismol) clarithromyocin (Biaxin) metronidazole (Flagyl) tetracycline (Achromycin V, Sumycin) | Antibiotics |
| ranitidine (Zantac) cimetidine (Tagamet) famotidine (Pepcid) nizatidine (Axid) | H2 Antagonists |
| SE- decreased libido and impotence CNS effects-lethargy, depression, confusion | Tagamet |
| Use caution with patients that have high risk for | pneumonia |
| H2 antagonists- concurrent use of this med can decrease absorption | antacids |
| Which H2 antagonist inhibits metabolizing enzymes? | cimetidine |
| omeprazole (Prilosec) pantoprazole (Protonix) | Proton Pump Inhibitor |
| Levels of digoxin, phenytoin, warfarin may be increased when taking | omeprazole |
| When to take PPIs | once a day before AM meal |
| Mucosal Protectant | sucralfate (Carafate) |
| sucralfate-to prevent constipation advise patients to | increase dietary fiber and drink at least 1500 mL/day |
| When to take sucralfate | 4x day, 1hr before meals and at bedtime |
| Interferes with absorption and should not take within 30 mins of sucralfate | antacids |
| aluminum hydroxide (Amphojel) aluminum carbonate (Basaljel) magnesium hydroxide (Milk of Magnesia) sodium bicarbonate calcium carbonate (Tums) | Antacids |
| Aluminum and calcium cause | constipation |
| Magnesium cause | diarrhea |
| Amphojel can lead to | hypophosphatemia and hypomagnesemia |
| Binds to warfarin and tetracycline and interfere with absorption. Take 1 hr apart | aluminum |
| How to take antacids | chew tablets thoroughly drink 8oz of water or milk |
| Take all meds one hour before taking | antacids |
| Prostaglandin | misoprostol (Cytotec) |
| Used to prevent gastric ulcers | misoprostol |
| Using magnesium antacids and misoprostol can increase | diarrhea |
| When to take misoprostol | meals and bedtime |
| Managing peptic ulcer disease | Avoid eating too many meals Avoid excessive intake of mile and cream Low dose aspirin is permitted Reduce stress wherever possible Avoid smoking |
| dexamethasone (Decadron) aprepitant (Emend) ondansetron (Zofran) gransisetron (Kytril) prochlorperazine, metoclopramide (Reglan) promethazine (Phenergan) dronabinol (Mairnol) lorazepam (Ativan) | Antiemetics |
| scopolamine dimenhydrinate (Dramamine) | treats motion sickness |
| Increase appetite in patients who have AIDS | dronabinol |
| SE of antiemetics | Hypotension, anticholinergic effects, sedation |
| SE only with prochlorperazine | Extrapyramidal symptoms- restlessness, anxiety, spasms of face and neck (RAS) |
| Tx of EPS | anticholinergics |
| psyllium (Metamucil) docusate sodium (Colace) bisacodyl (Dulcolax) magnesium hydroxide (Milk of Magnesia) senna (Senokot) lactulose (Cephulac) | Laxatives |
| Bulk-forming laxatives-softens fecal mass and increases bulk (like fiber) | psyllium |
| Surfactant laxatives- lowers surface tension of the stool to allow water in | docusate sodium |
| Stimulant laxatives- stimulates intestinal peristalsis | bisacodyl |
| Osmotic laxatives- draw water into the intestine to increase mass of stool | magnesium hydroxide |
| Side effects of laxatives | GI irritation, rectal burning |
| SE of magnesium hydroxide | magnesium toxicity |
| SE of sodium phosphate | risk of sodium absorption and fluid retention |
| Laxative contraindications | fecal impacation, bowel obstruction, nausea, cramping and abdominal pain |
| Interactions with bisacodyl | Milk and antacids- take 1 hr apart |
| Take psyllium and docusate with | glass of water |
| Time to take effect- laxatives | oral-6-12 hrs rectal 15 mins |
| diphenoxylate plus atropine (Lomotil) loperamide (Immodium) paregoric | Antidiarrheals |
| What should patients avoid when taking antidiarrheals? | Caffeine-increase GI motility Alcohol- enhances CNS effects Plain water |
| Prokinetic agents | metoclopramide (Reglan) |
| Which med blocks dopamine and seretonin receptors in the CTZ? | metoclopramide |
| Side effects of metoclopramide | sedation, EPS, diarrhea |
| What meds decrease effect of metoclopramide? | Opiods and anticholinergics |
| IBS with Diarrhea | alosetron (Lotronex) |
| How long does it take for alosetron to work? | 1-4 weeks |
| IBS with constipation | lubiprostone (Amitiza) |
| SE of lubiprostone | diarrhea and nausea |
| Contraindicated for patients with | hx of bowel obstruction, Crohns dz, ulcerative colitis, diverticulitis |
| When to take lubiprostone? | BID |
| sulfasalazine (Azulfidine) mesalamine (Asacol, Rowasa) Olsalazine (Dipentum) | 5-aminosalicylates |
| SE of 5-aminosalicylates | blood disorders nausea, cramps, rash, arthalgia |
| Alter the absorption of sulfasalazine | iron, antibiotics |
| Mesalamine decreases absorption of | digoxin |
| Used to tx numerous GI disorders (ex. c.diff) Consist of bacteria normally found in digestive tract | Probiotics |
| When to take probiotics | 2hr after antibiotics |
Created by:
vescobar
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