Bowel

• Antacids neutralizes stomach acid, acute relief 20-30 minutes Many available OTC


  maalox/mylanta/tums/milk of magnesium
• Antacids Side Effects


  constipation (rebound, hyperacidity from taking to often), white discoloration/ speckling stool
• Antacids Contraindication


  renal failure
• H-2 Receptor Antagonist : Common. Reduces acid, does not stop from excreting in tummy 


  cimetidine /famotidine /ranitidine* Not meant for long term use
• H-2 Receptor Antagonist Treatment 


  of GERD, peptic ulcer, erosive esophagitis, dyspepsia (indigestion), secondary GI bleed
• H-2 Receptor Antagonist Side Effects


  relatively safe, but can cause confusion in elderly
• H-2 Receptor Antagonist Avoid


  fried foods, acidic food, spicy, alcohol, coffee, bubbly soda, smoking because can decrease effect
• Proton-Pump Inhibitor : blocks/ inhibits all gastric secretions, OTC 


  lansoprazole /omeprazole /pantoprazole /esomeprazole* Not meant for long term use. given as last resort
• Proton-Pump Inhibitor Treatment 


  esophagitis, gerd, ulcers
• Proton-Pump Inhibitor Side Effects 


  can cause bruising, fatigue, diarrhea, rash, sore
• Proton-Pump Inhibitor Avoid


  warfarin because could cause increase bleeding, no smoking
• Anti-diarrheal : only used, if you know what is causing the diarrhea, OTC


  loperamide /bismuth salicylate

  Short term use
• Anti-diarrheal Side Effects


  black stool (normal), constipation (from over use)

  * not giving for food poisoning
• Bulk forming Laxatives 


  psyllium

  Fiber; increases bulk/ distention allows to move bowel easier
• Bulk forming Laxatives Educate

  must take with water, because if not enough water can cause opposite effectSafe to take every day, good for chronic constipation (older)
• Osmotic Laxatives: 


  polyethylene glycolPulls fluid into bowel which acts as stimulant, cleans out bowel
• Osmotic Laxatives For


  bowel prep
• Stimulant Laxatives


  bisacodyl, senna (most concerning)Increases motility, increases peristalsis
• Stimulant Laxatives


  Causes dependency!! (Rebound constipation/ decrease bowel tone)

  Short term!*