Gastrointestinal Drugs PDF 2022

GASTROINTESTINAL MEDICATIONS Drugs for Peptic Ulcer Disease—Chapter 37 Overview of Peptic Ulcer Disease and GERD 745 Overview of Drug Therapy 747 Pathophysiology Loss of protective layers; tissue exposed to acids and pepsin Ulcers occur in esophagus, stomach or duodenum Most common causes are: o NSA...

GASTROINTESTINAL MEDICATIONS Drugs for Peptic Ulcer Disease—Chapter 37 Overview of Peptic Ulcer Disease and GERD 745 Overview of Drug Therapy 747 Pathophysiology Loss of protective layers; tissue exposed to acids and pepsin Ulcers occur in esophagus, stomach or duodenum Most common causes are: o NSAID use o Helicobacter pylori—bacteria that causes ulcers o Stress o Cigarette smoking—delays healing and increases reoccurrence o Gastric acid and pepsin actually create the ulcer—if it was not there, ulcers would not form GERD—stomach acid refluxes in esophagus Clinical Manifestations o Gastric—dull aching pain right after eating; painless bleeding o Duodenal ulcers—heartburn, bloating, worse when stomach is empty, flares at night, food intake helps Major Classification Antacids—OTC, neutralize acid. Used to prevent and treat peptic ulcer disease and GERD Histamine-2 Receptor Antagonists Prototype: cimetidine interacts with many drugs Others: famotidine, ranitidine (less interference w/ drugs) Adverse effects occur infrequently, and usually mild Proton Pump Inhibitors Prototype: omeprazole; Others: pantoprazole Also minimal side effects, taken on empty stomach Adjuvant Medications: o Misoprostol (a prostaglandin) used with NSAIDs to prevent ulcers. BBW if pregnant (Category X) o Sucralfate—binds to the gastric mucosa o Antibiotics including bismuth subsalicylate Drugs for Nausea and Vomiting—Chapter 38 Overview of Nausea and Vomiting 765 Nausea—unpleasant sensation of abdominal discomfort Vomiting—expulsion of stomach contents up through the esophagus Anti-emetics—“against vomiting”—used to treat nausea and vomiting Overview of Phenothiazines (1st gen antipsychotics) Drug Therapy Prototype: promethazine These block dopamine. Classifications Prevents and treats n/v of surgery, anesthesia, migraines, 766 chemo, and motion sickness. Side effects are anti-cholinergic. Anti-histamines (H-1 receptor blocker) Prototype: hydroxyzine Serotonin Receptor Antagonists For moderate to severe n/v—chemo and post-op Prototype: ondansetron Drugs for Constipation and Elimination Problems Chapter 39 Overview Constipation—infrequent and painful expulsion of hard, dry stools Lifestyle changes—increased fiber, fluids and exercise Drug Bulk-forming—functions like increasing dietary fiber Classes for Example: psyllium Treating Surfactant—decrease surface tension to allow water to Constipation penetrate into the stool Example: docusate Stimulant laxatives Example: bisacodyl Osmotic (saline) laxatives Example: magnesium citrate Drugs for Diarrhea—increase in liquidity of stool or frequency of stool. Diarrhea Opioid-related: (antiPrototype: diphenoxylate with atropine diarrheal also loperimide meds) Side effects: tachycardia, dizziness Bismuth salts 2023