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GI Drugs
Drugs Affecting Gastrointestinal Secretions Drugs Used to Treat GERD and Ulcers
Term | Definition |
---|---|
Histamine-2 (H2) Antagonists Drugs | Cimetidine (Tagamet HB) Ranitidine (Zantac) Famotidine (Pepcid) Nizatidine (Axid) *ends in tidine* |
Histamine-2 (H2) Antagonists Actions | Actions Selectively block histamine-2 receptor sites This blocking leads to a reduction in gastric acid secretion and reduction in overall pepsin production |
Histamine-2 (H2) Antagonists Indications | Indications Short-term treatment of active duodenal ulcer or benign gastric ulcer Treatment of pathological hypersecretory conditions such as Zollinger–Ellison syndrome |
Histamine-2 (H2) Antagonists Indications continued | Indications continued Prophylaxis of stress-induced ulcers and acute upper GI bleeding in critical patients Treatment of erosive gastroesophageal reflux Relief of symptoms of heartburn, acid indigestion, and sour stomach (OTC preparations) |
Histamine-2 (H2) Antagonists Pharmacokinetics | Pharmacokinetics Readily absorbed after oral administration Metabolized in the liver and excreted in urine |
Histamine-2 (H2) Antagonists Contraindications | Contraindications Known allergy |
Histamine-2 (H2) Antagonists Caution | Caution Pregnancy or lactation Hepatic or renal dysfunction |
Histamine-2 (H2) Antagonists Adverse Effects | Adverse Effects GI effects CNS effects Cardiac arrhythmias and hypotension |
Histamine-2 (H2) Antagonists Drug-Drug Interactions | Drug-Drug Interactions Warfarin, phenytoin, beta blockers, alcohol, quinidine, lidocaine, theophylline, chloroquine, benzodiazepines, nifedipine, pentoxifylline, tricyclics, procainamide, and carbamazepine |
Antacids Drugs | Sodium bicarbonate (Bell-ans) Calcium carbonate (Oystercal, Tums, and others) Magnesium salts (Milk of Magnesia, and others) Aluminum salts (Amphojel, and others) |
Antacids Actions | Actions Neutralize stomach acid by direct chemical reaction |
Antacids Indications | Indications Symptomatic relief of upset stomach associated with hyperacidity, as well as hyperactivity |
Antacids Contraindications | Contraindications Allergy |
Antacids Caution | Caution Any condition that can be exacerbated by electrolyte imbalance GI obstruction |
Antacids Adverse Effects | Adverse Effects Relate to their effects on acid-base levels and electrolytes Rebound acidity Alkalosis Hypercalcemia Constipation or diarrhea Hypophosphatemia |
Antacids Drug-Drug Interactions | Drug-Drug Interactions Affect the absorption of many other drugs |
Proton Pump Inhibitors Drugs | Omeprazole (Prilosec) Esomeprazole (Nexium) Lansoprazole (Prevacid) Dexlansoprazole (Kapidex) Pantoprazole (Protonix) Rabeprazole (Aciphex) |
Proton Pump Inhibitors Actions | Actions Act at specific secretory surface receptors to prevent the final step of acid production and thereby decrease the level of acid in the stomach |
Proton Pump Inhibitors Indications | Indications Short-term treatment of active duodenal ulcers, GERD, erosive esophagitis, and benign active gastric disease Long-term treatment of pathological hypersecretory conditions |
Proton Pump Inhibitors Pharmacokinetics | Pharmacokinetics Acid labile, rapidly absorbed in the GI tract Metabolized in the liver and excreted in the urine |
Proton Pump Inhibitors Contraindications | Contraindications Allergy |
Proton Pump Inhibitors Caution | Caution Pregnancy or lactation |
Proton Pump Inhibitors Adverse Effects | Adverse Effects CNS effects: Dizziness, headache, asthenia, vertigo, insomnia, apathy GI Effects: Diarrhea, abdominal pain, and tongue atrophy |
Proton Pump Inhibitors Adverse Effects continued | Adverse Effects Upper respiratory tract symptoms: Cough, stuff nose, hoarseness, and epistaxis Other: Rash, alopecia, pruritis, dry skin, back pain, and fever |
Proton Pump Inhibitors Drug-Drug Interactions | Drug-Drug Interactions Benzodiazepines, phenytoin, warfarin Ketoconazole, theophylline Sucralfate Clopidogrel |
GI Protectant drugs | Sucralfate (Carafate) |
GI Protectant Actions | Actions Forms an ulcer-adherent complex at duodenal ulcer sites, protecting the sites against acid, pepsin, and bile salts |
GI Protectant Indications | Indications Promote ulcer healing |
GI Protectant Pharmacokinetics | Pharmacokinetics Rapidly absorbed, metabolized in the liver, and excreted in feces |
GI Protectant Contraindications | Contraindications Allergy / Renal failure |
GI Protectant Caution | Caution Pregnancy or lactation |
GI Protectant Adverse Effects | Adverse Effects GI effects – Constipation, diarrhea, nausea, indigestion, gastric discomfort, dry mouth Dizziness Sleepiness Vertigo Skin rash Back pain |
GI Protectant Drug-Drug Interactions | Drug-Drug Interactions Aluminum salts Phenytoin, fluoroquinolone, or penicillamine |
Prostaglandin Drugs | Synthetic prostaglandin E1 analogue misoprostol (Cytotec) |
Prostaglandin Actions | Actions Inhibits gastric acid secretion and increases bicarbonate and mucous production in the stomach |
Prostaglandin Pharmacokinetics | Pharmacokinetics Rapidly absorbed from GI tract, metabolized in the liver, and excreted in the urine |
Prostaglandin Contraindications | Contraindications Pregnancy |
Prostaglandin Caution | Caution Lactation |
Prostaglandin Adverse Effects | Adverse Effects GI effects – Nausea, diarrhea, abdominal pain, flatulence, vomiting, dyspepsia, and constipation GU effects – Miscarriages, excessive bleeding, spotting, cramping, hypermenorrhea, dysmenorrhea, and other menstrual disorders |
Digestive Enzymes Drugs | Saliva substitute (Mouth Kote, Salivart) Pancrelipase (Creon, Pancrease |
Digestive Enzymes Actions | Actions Saliva substitute – Contains electrolytes and carboxymethylcellulose to act as a thickening agent in dry mouth conditions Pancreatic enzymes are replacement enzymes that help the digestion and absorption of fats, proteins, and carbohydrates |
Digestive Enzymes Indications | Indications Replacement therapy |
Digestive Enzymes Contraindications | Contraindications Saliva – Allergy Pancreatic enzymes - Allergy |
Digestive Enzymes Caution | Caution Saliva – CHF, hypertension, or renal failure Pancreatic enzyme – Pregnancy and lactation |
Digestive Enzymes Adverse Effects | Adverse Effects Saliva – Complications from abnormal electrolytes – increased levels of magnesium, sodium, or potassium Pancreatic enzyme – GI irritation, nausea, abdominal cramps, and diarrhea |