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Cimetidine
- Acid reducing agent in the H2-receptor anatagonist class
- Competitive inhibition of H2 receptors on parietal cells
- Use for Ulcers, ZE syndrome, GERD
- Anti-androgen side ffects--male dysfunction--gynecomastia
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Famotidine
- Acid reducing agent in the H2 receptor antagonist class
- Competitive inhibition of H2 receptors on parietal cells
- Use for Ulcers, ZE syndrome, and GERD
- Headaches and diarrhea
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Nizatidine
- Acid reducing agent in the H2 receptor antagonist class
- Competitive inhibition of H2 receptors on parietal cells
- Use for ulcers, ZE syndrome, and GERD
- Headaches, n/v
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Esomeprazole
- Acid reducing agent in the PPI class
- Irreversible inhibition of the H/KATPase transporter in gastric parietal cells (24-48 hr acid block)
- Use for ulcers, ZE syndrome, GERD, esophagitis, and H pylori gastritis
- No side effects
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Omeprazole
- Acid reducing agent in the PPI class
- Irreversible inhibition of the H/KATPase transporter in gastric parietal cells (24-48 hr acid block)
- Use for ulcers, ZE syndrome, GERD, esophagitis, and H pylori gastritis
- No side effects
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Lansoprazole
- Acid reducing agent in the PPI class
- Irreversible inhibition of the H/KATPase trasnproter in gastric parietal cells (24-48 hr acid block)
- Use for ulcers, ZE syndrome, GERD, esophagitis, and H pylori gastritis
- No side effects
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Aluminum hydroxide
- Acid reducing agent in the antacid class
- Neutralizes secreted gastric acid
- Use for acute dyspepsia (heartburn)
- Constipation, n/v
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Calcium carbonate
- Acid reducing agent in the antacid class
- Neutralizes secreted gastric acid
- Use for acute dyspepsia
- Constipation, belching, nausea, flatulence
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Magnesium hydroxide
- Acid reducing agent in the antacid class
- Neutralizes gastric acid
- Use for acute dyspepsia
- Diarrhea
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Misoprostol
- Acid reducing agent in the PG E1 analog class
- Reduces acid secretion from parietal cells and stimualtes mucin and bicarb secretion--also increases mucosal blood flow
- Use to prevent NSAID induced ulcers
- Diarrhea and abdominal pain; do not use in pregnancy
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Sucralfate
- Acid reducing agent in the sulfated polysaccharide class
- Forms a protective barrier on the gastric mucosa inhibiting pepsin hydrolysis of epithelium; induces PG formation
- Use to heal duodenal ulces
- Constipation
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Bismuth subsalicylate (peptobismol)
- Locally acting acid reducing agent and anti-diarrheal agent
- Protects gastric mucosa and decreases intestinal motility
- Use for ulcers, dyspepsia, and traveler's diarrhea
- Darkened tongue and stools
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Loperamide
- Anti-diarrheal agent in the opioid receptor agonist class
- Blocks ACh in ENS-->decreased peristalsis and motility causing increased GI transit time
- Use for diarrhea
- GI discomfort
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Diphenoxylate
- Anti-diarrheal agent in the opioid receptor agonist class
- Blocks ACh in ENS-->decreased peristalsis and motility causing increased GI transit time
- Use for diarrhea
- GI discomfort
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Kaolin-Pectin
- Locally acting anti-diarrheal agent
- Absorbent demulcent
- Use for diarrhea
- Cosntipation and dehyrdation
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Docusate
- Laxative in the stool softener class
- Reduces surface tension of oil-water interface of stool enhancing incorporation of water and fat
- Use for constipation, prevention of straining during defecation (ie hospital patients)
- Orally or rectally
- GI cramping
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Mineral Oil
- Laxative in the stool softener class
- Lubricates bowel and decreases water absorption
- Use for constipation, prevention of straining during defectation
- Orally or rectally
- GI cramping
-
Glycerin
- Laxative in the stool softener class
- Draws fluid into colon (osmotic pressure)
- Use for constipation, prevention of straining during defectation
- Orally or rectally
- GI cramping
-
Glycerin
- Laxative in teh bulk forming (viscous fiber) class
- Produces viscous liquid in bowel that promotes peristalsis and reduces transit time
- Use for constipation and prevention of straining during defecation
- Esophageal or bowel obstruction if not given with sufficient liquid; flatulence
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Diphenhydramine and Meclizine
- Anti-emetic agent in the H1 receptor antagonist class
- Competitive inhibition of H1 receptors on effector cells in the GI tract
- Use for motion sickness
- Sedation (CNS effects)
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Ondansetron and Granisetron
- Anti-emetic agents in the 5-HT3 receptor antagonist class
- Blocks action of serotonin on enteric nerves and CNS preventing classic emetic response
- Use for chemotherapy induced n/v and post-operative n/v
- mild side effects
-
Metoclopramide
- Anti-emetic agent in the dopamine D2-receptor antagonsit class
- prokinetic: stimulates antral and small bowel contractions to enhance transit
- Use for post-operative gastroparesis
- Mild side effects
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Dronabinol
- Anti-emetic agent in the cannabinoid class
- Unknown mechanism (receptors in CNS?)
- Use for chemo-induced n/v and AIDS-related anorexia
- Altered mental status
-
Triple therapy
- Clarithromycin, Amoxicillin, and PPI
- Anti-microbial effects; used to treat infection with H pylori to prevent or ameliorate induced inflammatory gastritis and PUD (10-14 day treatment)
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