GI Drugs


Cimetidine


Acid reducing agent in the H2-receptor anatagonist classCompetitive inhibition of H2 receptors on parietal cellsUse for Ulcers, ZE syndrome, GERDAnti-androgen side ffects--male dysfunction--gynecomastia


Famotidine


Acid reducing agent in the H2 receptor antagonist classCompetitive inhibition of H2 receptors on parietal cellsUse for Ulcers, ZE syndrome, and GERDHeadaches and diarrhea


Nizatidine


Acid reducing agent in the H2 receptor antagonist classCompetitive inhibition of H2 receptors on parietal cellsUse for ulcers, ZE syndrome, and GERDHeadaches, n/v


Esomeprazole


Acid reducing agent in the PPI classIrreversible 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 gastritisNo side effects


Omeprazole


Acid reducing agent in the PPI classIrreversible 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 gastritisNo side effects


Lansoprazole


Acid reducing agent in the PPI classIrreversible 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 gastritisNo side effects


Aluminum hydroxide


Acid reducing agent in the antacid classNeutralizes secreted gastric acidUse for acute dyspepsia (heartburn)Constipation, n/v


Calcium carbonate


Acid reducing agent in the antacid classNeutralizes secreted gastric acidUse for acute dyspepsiaConstipation, belching, nausea, flatulence


Magnesium hydroxide


Acid reducing agent in the antacid classNeutralizes gastric acidUse for acute dyspepsiaDiarrhea


Misoprostol


Acid reducing agent in the PG E1 analog classReduces acid secretion from parietal cells and stimualtes mucin and bicarb secretion--also increases mucosal blood flowUse to prevent NSAID induced ulcersDiarrhea and abdominal pain; do not use in pregnancy


Sucralfate


Acid reducing agent in the sulfated polysaccharide classForms a protective barrier on the gastric mucosa inhibiting pepsin hydrolysis of epithelium; induces PG formationUse to heal duodenal ulcesConstipation


Bismuth subsalicylate (peptobismol)


Locally acting acid reducing agent and anti-diarrheal agentProtects gastric mucosa and decreases intestinal motilityUse for ulcers, dyspepsia, and traveler's diarrheaDarkened tongue and stools


Loperamide


Anti-diarrheal agent in the opioid receptor agonist classBlocks ACh in ENS-->decreased peristalsis and motility causing increased GI transit timeUse for diarrheaGI discomfort


Diphenoxylate


Anti-diarrheal agent in the opioid receptor agonist classBlocks ACh in ENS-->decreased peristalsis and motility causing increased GI transit timeUse for diarrheaGI discomfort


Kaolin-Pectin


Locally acting anti-diarrheal agentAbsorbent demulcentUse for diarrheaCosntipation and dehyrdation


Docusate


Laxative in the stool softener classReduces surface tension of oil-water interface of stool enhancing incorporation of water and fatUse for constipation, prevention of straining during defecation (ie hospital patients)Orally or rectallyGI cramping


Mineral Oil


Laxative in the stool softener classLubricates bowel and decreases water absorptionUse for constipation, prevention of straining during defectationOrally or rectallyGI cramping


Glycerin


Laxative in the stool softener classDraws fluid into colon (osmotic pressure)Use for constipation, prevention of straining during defectationOrally or rectallyGI cramping


Glycerin


Laxative in teh bulk forming (viscous fiber) classProduces viscous liquid in bowel that promotes peristalsis and reduces transit timeUse for constipation and prevention of straining during defecationEsophageal or bowel obstruction if not given with sufficient liquid; flatulence


Diphenhydramine and Meclizine


Anti-emetic agent in the H1 receptor antagonist classCompetitive inhibition of H1 receptors on effector cells in the GI tractUse for motion sicknessSedation (CNS effects)


Ondansetron and Granisetron


Anti-emetic agents in the 5-HT3 receptor antagonist classBlocks action of serotonin on enteric nerves and CNS preventing classic emetic responseUse for chemotherapy induced n/v and post-operative n/vmild side effects


Metoclopramide


Anti-emetic agent in the dopamine D2-receptor antagonsit classprokinetic: stimulates antral and small bowel contractions to enhance transitUse for post-operative gastroparesisMild side effects


Dronabinol


Anti-emetic agent in the cannabinoid classUnknown mechanism (receptors in CNS?)Use for chemo-induced n/v and AIDS-related anorexiaAltered mental status


Triple therapy


Clarithromycin, Amoxicillin, and PPIAnti-microbial effects; used to treat infection with H pylori to prevent or ameliorate induced inflammatory gastritis and PUD (10-14 day treatment)