Carlos Shared "20 Gastrointestinal Pharm" - 14 Picmonics
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20 Gastrointestinal Pharm
Acid suppression therapy
H2 Receptor Blocker
- "-tidine" Suffix
- Indications
- Gastroesophageal Reflux Disease (GERD)
- Peptic Ulcer
- Mechanism
- Block Histamine H2 Receptors
- Parietal Cells
52 secs
Proton Pump Inhibitors (PPIs)
- "-prazole" Suffix
- Indications
- Zollinger-Ellison Syndrome
- Gastritis
- Peptic Ulcer
- Gastroesophageal Reflux Disease (GERD)
- Mechanism
- Inhibit H+/K+/ATPase
- Side Effects
- Hip fracture
- Pneumonia
2 mins
Antacids
- All
- Can affect absorption, bioavailability, or urinary excretion of other drugs by altering gastric and urinary pH or by delaying gastric emptying
- All can cause hypokalemia
- Aluminum hydroxide
- SE: Constipation and hypophosphatemia; proximal muscle weakness, osteodystrophy, seizures
- Calcium carbonate
- SE: Hypercalcemia (milk-alkali syndrome), rebound acid increase
- Can chelate drugs and decreases effectiveness (eg tetracycline)
- Magnesium hydroxide
- SE: Diarrhea, hyporeflexia, hypotension, cardiac arrest
Sucralfate (Carafate)
- Mechanism
- Creates Protective Barrier
- Indications
- GI Ulcers
- Side Effects
- Constipation
- Considerations
- Require Acidic Environment
- Give on Empty Stomach
- Oral Suspension Available
- May Decrease Absorption of Other Meds
2 mins
Dinoprostone and Misoprostol
- Mechanism
- Prostaglandins
- Indications
- Promote Cervical Ripening
- Prevent GI Ulcers
- Medical Abortion
- Side Effects
- Fetal Distress
- Hyperstimulation of Uterus
- Considerations
- Vaginal Insertion
- Give Before Induction of Labor
2 mins
Octreotide
- Indications
- Acute Variceal Bleeds
- Pituitary Tumors
- GH Secreting Tumors
- Carcinoid Tumors
- VIPoma
- Mechanism
- Somatostatin Analog
2 mins
Sulfasalazine
- MECHANISM
- A combination of sulfapyridine (antibacterial) and 5-aminosalicylic acid (anti-inflammatory).
- Activated by colonic bacteria.
- CLINICAL USE
- Ulcerative colitis, Crohn disease (colitis component).
- Rheumatoid arthritis
- ADVERSE EFFECTS
- Malaise, nausea, sulfonamide toxicity, reversible oligospermia.
- Also DRESS syndrome and pancreatitis
Loperamide
- MECHANISM: Agonist at μ-opioid receptors; slows gut motility. Poor CNS penetration (low addictive potential).
- CLINICAL: USE Diarrhea.
- ADVERSE EFFECTS: Constipation, nausea.
Ondansetron
- Indications
- Postoperative Vomiting
- Chemotherapy-induced Nausea and Vomiting
- Mechanism
- 5-HT3 Serotonergic Antagonist
- Centrally-acting Antiemetic
- Side Effects
- Headache
- Constipation
- QT Prolongation
1 min
Metoclopramide
- Indications
- Antiemetic
- Promotility Agent
- Mechanism
- Increased Resting Tone
- Antagonist at D2 Receptor
- Side Effects
- Parkinsonian Symptoms
- Galactorrhea
- Contraindication
- Small Bowel Obstruction
- Parkinson's Disease
2 mins
Orlistat
- MECHANISM: Inhibits gastric and pancreatic lipase leads to decreased breakdown and absorption of dietary fats.
- CLINICAL USE: Weight loss
- ADVERSE EFFECTS: Steatorrhea, decreased absorption of fat-soluble vitamins.
Laxatives
- Indicated for constipation or patients on opiates requiring a bowel regimen
- Bulk-forming laxatives
- NAMES: Psyllium, methylcellulose
- MECHANISM: Soluble fibers; draw water into gut lumen, forming a viscous liquid that promotes peristalsis
- ADVERSE EFFECTS: Bloating
- Osmotic laxatives
- NAMES: Magnesium hydroxide, magnesium citrate, polyethylene glycol, lactulose
- MECHANISM: Provide osmotic load to draw water into GI lumen. Lactulose also treats hepatic encephalopathy because gut flora degrade it into metabolites (lactic acid, acetic acid) that promote nitrogen excretion as NH4 +
- ADVERSE EFFECTS: Diarrhea, dehydration; may be abused by bulimics
- Stimulants
- NAME: Senna
- MECHANISM: Enteric nerve stimulation leads to colonic contraction
- ADVERSE EFFECTS: Diarrhea, melanosis coli
- Emollients
- NAME: Docusate
- MECHANISM: Osmotic draw into lumen causes increased water absorption by stool
- ADVERSE EFFECTS: Diarrhea
Aprepitant
- MECHANISM: Substance P antagonist. Blocks NK1 receptors in brain.
- CLINICAL USE: Antiemetic for chemotherapy-induced nausea and vomiting.
