-
Treat C. difficile
Metronidazole or vancomycin PO
-
Risks of short term PPI use
Increased risk of pneumonia
-
risks for long term use of PPIs
- Fractures,
- hypomagnesia,
- c. diff
-
Drugs that interact with PPIs
Clopidogrel, diazepam
-
Duration of PPI treatment for upper GI bleed
4-8 weeks
-
antacids should not be given with which antibiotics
Tetracyclines and fluoroquinolones
-
which antacids should be avoided in renal insufficiency
Aluminum and magnesium (and combination)
-
sucralfate
- binds to ulcer site
- may cause constipation
- administer 30 minutes apart if giving antacid also
-
side effects of H2 blockers
Headache, dizziness, CNS disturbances, rash, pruritis
-
2 examples of H2 blockers
- Famotidine: Pepcid: 10-40 mg
- ranitidine: Zantac: 75-300 mg
-
medication to prevent nsaid ulcers
misoprostol: prostaglandin analogue TERATOGENIC
-
metoclopramide / Reglan
- Increases motility,
- suppresses nausea/vomiting.
- adverse effects: tardive dyskinesia, extrapyramidal symptoms, diarrhea, sedation
-
adverse effects of erythromycin as a pro kinetic
Nausea/vomiting, QT prolongation, change in gut biome
-
preferred steroid for inflammatory bowel flare ups
Budesonide
-
adverse effects of remicade/infliximab
Hepatitis, vasculitis, bone marrow suppression, infection, heart failure exacerbation, fever, rash, pruritis
-
Adverse effects of methotrexate
Bone marrow suppression, liver toxicity, pulmonary toxicity
-
monoclonal antibody anti diarrheal
humira, remicade
-
antidiarrheal
loperamide / Imodium
-
antispasmodic
Dicyclomine / bentyl
-
Bile acid binder
Cholestyramine
-
contraindications for laxative use
Undiagnosed abdominal pain, cramps, obstruction, diverticulitis, ulcerative colitis
-
good laxative for IBS and diverticulitis
Bulk forming: psyllium
-
senna
stimulant laxative, often used for opioid users. Can discolor urine.
-
laxative safe for pregnancy
psyllium
-
surfactant laxative
Colace. Soften stools
-
saline osmotic
softens stool, helps peristalsis
-
adverse reactions of saline osmotics
water loss, toxic Mg or K levels in pts with renal insufficiency
-
contraindications to saline osmotics
Heart failure, cirrhosis, renal dysfunction
-
Drugs that cause diarrhea
Levothyroxine, NSAIDs, sorbitol, digoxin, colchicine
-
least abuseable opioid anti diarrheal
Imodium ( doesn’t cross BBB)
-
pesto bismol mechanism of action and generic name
binds toxins. Coats lining. Bismuth subsalicylate
-
treat mild to moderate community acquired peritonitis
Cefoxitin, moxifloxacin
-
treat high risk, severe, or hospital acquired peritonitis
Zosyn, or cefipime + metronidazole
-
antibiotics for prophylaxis in variceal bleed patients
Ceftriaxone, Bactrim, or a fluoroquinolone
-
best antidiarrheal for HIV associated diarrhea
Octreotide
-
Prostaglandin analogue to prevent NSAID ulcer
- Misoprostol / Cytotec
- contraindicated in women of childbearing age
-
patient instructions and warnings when prescribing PPI
Supplement with calcium and vitamin d to reduce fracture risk, avoid those with influenza like illnesses
-
What antacids are appropriate for patients with renal failure?
Calcium / Tums
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