Tanner Shared "GI system" - 36 Picmonics

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GI system

Ondansetron
Indications
Postoperative Vomiting
Chemotherapy-induced Nausea and Vomiting
Mechanism
5-HT3 Serotonergic Antagonist
Centrally-acting Antiemetic
Side Effects
Headache
Constipation
QT Prolongation
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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
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2 mins
Promethazine (Phenergan)
Mechanism
Histamine H1 Receptor Antagonist
Weak Dopamine Antagonist
Indications
Nausea and Vomiting
Motion Sickness
Side Effects
Respiratory Depression
Sedation
Anticholinergic Effects
Extrapyramidal Symptoms
Considerations
Use Large Bore IV
Monitor for Tissue Necrosis
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2 mins
Bulk-Forming Laxatives
Bulk-forming Laxatives
Psyllium (Metamucil)
Methylcellulose (Citrucel)
Polycarbophil (Fibercon)
Uses
geriatric
Pregnancy
Drug Interactions
Binds to other drugs and reduces absorption
Contraindications
Stenosis
Ulceration
Fecal obstruction
Other uses
Mild diarrhea
Irritable Bowel Syndrome
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Emollient Laxatives
Emollient Laxatives
Docusate sodium (Colace)
Uses
After Myocardial Infarction
Post rectal surgery
Opioids
Pregnant Women
Contraindications
Appendicitis
Fecal impaction
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Lubricants
Lubricants
Mineral Oil
CAUTION
Chronic use
Elderly
Risk of Aspiration
Fat soluable vitamins
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Stimulant Laxatives
Diphenylmethane Derivatives
Bisacodyl (Dulcolax):
Indications
Children >12 years old
ADR's
Avoid with antacids/milk
Pink Colored urine/feces
Atonic Colon
Anthraquinone Laxatives
Senna (Senokot)
Indications
Same as Bisacodyl
ADR's
Yellow-brown to red urine
Interstitial Nephritis
Atonic Colon
Contraindications
Pregnancy
Interstitial Nephritis
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Saline Cathartics
Saline Cathartics
Magnesium Hydroxide
Magnesium Sulfate
Sodium phosphate
Magnesium citrate
Castor Oil
Glycerin Suppository
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Glycerin/Hyperosmotic
Polyethylene glycol
Polyethylene glycol
GoLytely
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Opioid Induced Constipation (OIC)
Noloxegol - Movantik
Noloxegol
MOA
Peripheral opioid Antagonist
Lubiprostone - Amitiza
Lubiprostone (Amitiza)
MOA
Chloride Channel Activator
Contraindications
Pregnancy
Intestinal Obstruction
Methylnaltrexone - Relistor
Methylnaltrexone
MOA
Peripherally acting Mu antagonist
Naldemedine - Symproic
Naldemedine
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Antimotility Drugs
Lomotil
Lomotil
Slow intestinal transit
Clostridium difficile
Loperamide (Imodium)
Loperamide
intestinal muscles
Contraindications
Diphenoxylate
Diphenoxylate
Paregoric
Paregoric
Difenoxin
Difenoxin
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Absorbants
Kaolin-Pectin
Kaolin-Pectin
MOA
Polycarbophil
Polycarbophil
Attapulgite
Attapulgite
Cholestryamine
Cholestryamine
MOA
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Octreotide (Sandostatin)
MOA
5-HT3 Serotonergic Antagonist
Indications
Metastatic Vasoactive intestinal peptide-secreting tumor associated diarrhea
ADR
Bradycardia
Hyperglycemia
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Atropine
Indications
Blocks DUMBBeLSS
Bradycardia
Side Effects
Skin Flushing
Increased Temperature
Dry Mouth
Cycloplegia
Disorientation
Mydriasis
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1 min
Traveler's Diarrhea Workup
Prophylaxis
Bismuth subsalicylate
Treatment
Oral Rehydration
Fluoroquinolones
Ciprofloxacin
Azithromycin
Rifaxamin
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Irritable Bowel Syndrome (IBS) Assessment
Abdominal Pain
Relieved by Defecation
Alternating Diarrhea and Constipation
Fatigue
Excessive Flatulence
Sensation of Incomplete Evacuation
Considerations
Stressors
Food Intolerances
More Common in Women
Rule Out Other Disorders
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2 mins
Irritable Bowel Syndrome (IBS) Interventions
Interventions
Identify Triggers
Increase Fiber Intake
Probiotics
Anticholinergics
Tricyclic Antidepressants (TCAs)
Loperamide
Linaclotide
Medications for Women
Tegaserod (Zelnorm)
Lubiprostone (Amitiza)
Alosetron (Lotronex)
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2 mins
Aminosalicylates
Sulfasalazine (Azulfidine)
Sulfasalazine
Contraindications
Salicylate Hypersensitivity or Sulfa Allergies
Renal Impairmet
ADR's
Blood disorders
Folic Acid absorption impaired
Low Sperm counts
Drug-induced Lupus
Mesalamine
Mesalamine
Indications
Suppository
Delayed Release Formulations
ADR's
Better Tolerated than sulfasalazine
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Azathioprine (Imuran)
Mechanism
Antimetabolite
Prodrug of 6-mercaptopurine (6-MP)
Inhibits Synthesis of Nucleic Acids
Indications
Autoimmune Disorders
Kidney Transplantation
Side Effects
Myelosuppression
Increased Toxicity with Allopurinol Use
Pancreatitis
Malignancy
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3 mins
TNF-Alpha Inhibitor Drugs and Complications
Etanercept
Decoy TNF- Alpha receptor
Anti-TNF- Alpha antibody
Adalimumab
Infliximab
Complications
Increased risk of infection
Predispose to Tuberculosis (TB) reactivation
Order Baseline PPD- skin test
Quantiferon Gold In-Tube
Order Chest X-Ray
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2 mins

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