GI medications

• Antacids neutralize acids
• Antacids ADR: Constipation, Diarrhea, & Metabolic Alkalosis
• Antacids treatment time: Do not take any medication before or after the medication. Wait 1-2hrs after taking the medication.
• Calcium Carbonate: releases CO2 in the stomach causes it to be bloated. It is a high neutralize acid. The brand name is TUMS. ADR: Hypercalemia
• Magnesium Hydroxide: Drug: Milk of MG. ADR: NOT for pt with renal dysfunction
• Aluminum Hydroxide: low neutralize acid
• Antiflatulents breaks up gas bubbles to relieve bloating.

  Drug: Simethicone
• Anticholinergics blocks acetylcholine to decrease motility

  Drug family: "ine"
• Scopolamine prevents motion sickness

  Take it 4hrs before needed/intended use
• Histamine (H2) Antagonists blocks gastric release to decrease acids release

  Drug family name: "tidines" family
• Cimetidine has ADRS

  Gynecomastia: makes secondary breast tissue or ED problem

  Drowsy, risk for falls, and Bone marrow suppression
• Ranitidine was the drug of choice for Histamine Antagonist. It was stopped because it had carcinogen which caused pt cancer
• Proton Pump Inhibitor blocks proton acid pump. It is an irreversible inhibition. It has little GI motility so it can suppress acid without any interference. Only use for a short term. Unless pt with Zollinger-Ellison
• PPI is NOT for pt with acute heartburn.

  ADR: inhibit nutrient absorption of B12 and causes dementia
• PPI Drug family: "Prazole"

  Take 30 mins before meals and NO crushing or chewing them
• Mucosal Protectives - Sucrafate

  forms a sticky gel so it acts like a bandaid. It goes to ulcers and blocks the acid

  Bests works on an empty stomach!
• Mucosal Protective - Misoprostol

  Increasing HCO3 and mucus production while inhibiting acid. It is used for ulcers and can be combined with NSAIDS

  WARNING!! DO NOT give to pregnant women!!!! it was cause them to have spontaneous miscarriages and rips the cervics

  HOWEVER! if they are full terms then it can be used to go into labor
• GI stimulants: will increase motility and decrease acids

  ADR: Diarrhea, Drowsy, and Extrapyramid effects (EPS)

  Drug: Metoclopramide

  Can only be used for a short term!! Less than 12 weeks
• Antibiotic Therapy for Peptic Ulcer Disease (PUD)

  Can take 14 days for this therapy. Drugs will target the ulcer and antibiotic will target the microorganism.

  You would Bismuth - a coat stomach and relieves from ulcers

  You would use combo drugs

  PPI/H2 Antagonists - deals with acids and lining of stomach heals

  2 antibiotics: Clarithromycin or Anoxycillin OR cycline

  Use Metrodazole (Flagyl) because the Cilin will alter the stomachs flora causing C. diff to occur
• Anti-Emetics will stop pt from vomiting

  ADR: Drowsy

  • Promethazine - In PEDS = respiratory depression
  • Prochlorperazine inhibits vestibular stimulation
• Serotonin (5HT3) Blocker will block it at the vagal neuron & CTZ. 5TH3 will prevent nausea from coming. It is best used for pt in chemotherapy

  Drug Family: "Etrons"

  • Odansetron
  • Dolasetron
• Dronabinol (Marinol) has THC which is marijuana
• Droperidol causes serious cardiac arrhythmia. you NEED to monitor ECG for the QT interval. Usually given to psychotic pt to calm them down
• Emetics is meds for vomiting. Not recommended anymore because it pt throw up after ingesting poison or smth, it will kill them. We use Charcoal to absorb any overdose medication
• Antidiarrheal - Local

  Use Bismuth - stool and tongue to be darkened

  Be careful with Kaopectate

  Any meds that have Salicylate can't be used by kids/teens cause it causes Reye's syndrome!
• Antidiarrheal - Systemic

  ADR: Drowsy

  Drugs: Diphenoxylate/atropine

  Lopermide - no high dose or it'll cause arrhythmia or cardiac arrest
• Intestine flora has Lactobacillus acidophillus and we need to supress the growth of the diarrhea causing bacteria. If we have a lot of diarrhea them you can lose 5TH3 which can cause depression
• The Herb used for Antidiarrheal is Probiotic! Examples are any milk products
• Irritable Bowl Syndrome (IBS) causes cramping which can either be constipated or have diarrhea. You can manage this by diets, avoiding non-soluble fiber and raw fruits/veggies

  Drugs: Psyllium, Antispasmodies, or Tricycline antidepressent
• IBS - Constipation

  increase Gl Fluids

  Drugs: Linaclotide & Lubiprotone

  ADR: Dehydration and GI obstruct
• IBS - Diarrhea

  Eluxadoline is used 2 times a day. It can cause Euphoria and "Drunkness"

  ADR are pancreaitis, drowsy, and drunk

  WARNING: do not give to pt with liver dysfunction or alcoholics
• Inflammatory Bowel Disease (IBD) is a chronic condition that causes inflammation of the intestines. It will cause Crohn's Disease and Ulcerative Colitis.

  Drugs: Anti-diarrheal, Anti-inflammatory, & Glucocorticoid
• Laxatives is used for bowel movement. ADR will be Diarrhea, Abdominal cramping, malabsorption and nutrient deficiency. Tell pt to exercise to prevent constipation. Watch out for pt with anorexia as they might abuse this medication
• Stimulant laxatives will directly stimulate the intestinal wall to cause peristalsis. This will help with constipation. The side effects is having semi-fluid stool in 6-12hrs

  Drugs: Biscodyl, Senna, and Castor Oil
• Stool Softner is a gently option. It Prevents constipation, NOT a cure. It works for 1-3 days.

  Drug: Docusate
• Bulk forming laxative will swell with water to cause peristalsis. It will prevent constipation. it will take 1-3 days. It comes in a powder so mix it well and drink immediatly. After taking the medicine, take another glass of water.
• Osmotic Laxative forces fluids into intestine to force peristalsis. It works for 2-6hrs. We usually use this to prepare for surgery

  Drug: Polyethelene glycol
• Pancreatic Digestants will helps digestions to release enzymes to breakdown food. This med will help replaces pancreatic enzymes.

  Drugs: pancrelipase

  Make sure to drink lots of water!!
• Colon Cancer Agents - Bevacizumab (Avastin)

  will inhibit angiogenesis so it'll slow down blood flow to the tumor
• Colon Cancer Agent - Cetuximab

  Will block the growth of the tumor!