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    Gastrointestinal Drugs Handout

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    criselda desisto
    Gastrointestinal drugs can be classified into six main categories: 1. Anti-ulcer drugs such as H2 antagonists and proton pump inhibitors are used to treat ulcers and reflux. 2. Antacids provide relief from acid indigestion but can cause side effects like rebound acidity or electrolyte imbalances. 3. Laxatives stimulate bowel movements and are used for constipation relief before procedures or to remove toxins. 4. Gastrointestinal stimulants like metoclopramide promote GI motility. 5. Antidiarrheal drugs like loperamide slow intestinal activity to treat diarrhea. 6. Each drug has specific

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    Gastrointestinal Drugs Handout

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    criselda desisto
    32 views3 pages
    Gastrointestinal drugs can be classified into six main categories: 1. Anti-ulcer drugs such as H2 antagonists and proton pump inhibitors are used to treat ulcers and reflux. 2. Antacids provide relief from acid indigestion but can cause side effects like rebound acidity or electrolyte imbalances. 3. Laxatives stimulate bowel movements and are used for constipation relief before procedures or to remove toxins. 4. Gastrointestinal stimulants like metoclopramide promote GI motility. 5. Antidiarrheal drugs like loperamide slow intestinal activity to treat diarrhea. 6. Each drug has specific

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    Gastrointestinal drugs can be classified into six main categories: 1. Anti-ulcer drugs such as H2 antagonists and proton pump inhibitors are used to treat ulcers and reflux. 2. Antacids provide relief from acid indigestion but can cause side effects like rebound acidity or electrolyte imbalances. 3. Laxatives stimulate bowel movements and are used for constipation relief before procedures or to remove toxins. 4. Gastrointestinal stimulants like metoclopramide promote GI motility. 5. Antidiarrheal drugs like loperamide slow intestinal activity to treat diarrhea. 6. Each drug has specific

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    32 views3 pages

    Gastrointestinal Drugs Handout

    Uploaded by

    criselda desisto
    Gastrointestinal drugs can be classified into six main categories: 1. Anti-ulcer drugs such as H2 antagonists and proton pump inhibitors are used to treat ulcers and reflux. 2. Antacids provide relief from acid indigestion but can cause side effects like rebound acidity or electrolyte imbalances. 3. Laxatives stimulate bowel movements and are used for constipation relief before procedures or to remove toxins. 4. Gastrointestinal stimulants like metoclopramide promote GI motility. 5. Antidiarrheal drugs like loperamide slow intestinal activity to treat diarrhea. 6. Each drug has specific

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    Gastrointestinal Drugs

    Anti-ulcer drugs:
    I. Histamine-2 (H2) Antagonists
    - selectively block H2 receptors (located on parietal cells) blocking gastrin which causes
    local release of histamine and production of hydrochloric acid (Hcl) and decrease pepsin.

    Drugs
    A. cimetidine (Tagamet) - first drug to be developed- has antiadrenergic effects including
    gynecomastia and galactorrhea
    B. ranitidine (Zantac) - longer acting and more potent than cimetidine - NOT associated
    with anti-adrenergic adverse effects

    Actions and indications


    - short-term treatment of active duodenal ulcer or benign gastric ulcer - prophylaxis
    of stress-induced ulcers and acute upper GI bleeding in critical clients - treatment
    of erosive gastroesophageal reflux
    - relieve symptoms of heartburn, acid indigestion and sour stomach (OTC preparations)

    Contraindications and cautions


    - caution for pregnancy or lactation and with hepatic or renal dysfunction

    Adverse effects
    GI - diarrhea or constipation
    CNS - dizziness, headache, somnolence, confusion
    Cardio - arrhythmias and hypotension - more commonly seen with IV or IM or with
    prolonged use
    - gynecomastia (more common with long term use of cimetidine) and impotence

    II. Antacids
    - neutralize stomach acid, available OTC; ALL antacids have adverse effects - no perfect
    antacid
    - giving antacid frequently causes acid rebound - nuetralizing the stomach contents to
    alkaline level stimulates gastrin production to cause increased in acid production and
    return stomach to its normal acidic state - therefor acid rebound causes increased intake of
    antacid
    - clients taking antacids should be advised to seperate them from any other drugs by 1 to 2
    hours

    Drugs
    A. sodium bicarbonate (Bell-Ans) - oldest drug in this group - includes baking soda B.
    calcium carbonate (Tums) - actually precipitated chalk
    C. magnesium salts (Milk of Magnesia) - very effective in buffering acid in stomach but
    can cause diarrhea
    D. aluminum salts (Amphojel) - do NOT cause acid rebound but NOT very effective in
    acid neutralizing

    Actions and indications


    - for symptomatic relief of upset stomach associated with hyperacidity as well as
    hyperacidity with peptic ulcer, gastritis, gastirc hyperacidity and hiatal hernia

    Contraindications and cautions


    - those clients that can exacerbate by electrolyte or acid-base imbalance, GI obstruction
    can cause systemic absorption, renal dysfunction can lead to electrolyte imbalance,
    pregnancy or lactation

    Adverse effects
    - rebound acidity produce more acid in repsonse to alkaline environment is common
    - use of calcium salts may lead to hypercalcemia and milk-alkali syndrome -
    constipation or diarrhea
    - hypophosphatemia with use of aluminum salts
    - fluid retention and CHF can occur with sodium bicarbonate beacuse of high sodium
    content
    III. Proton pump inhibitors (gastric acid pump)
    - suppress gastric acid secretion by inhibiting hydrogen-potassium adenosine
    triphosphatase enzyme system on secretory surface of gastric parietal cells - blocking
    final step of acid production

    Drugs
    A. omeprazole (Omperon) - faster acting and more quickly excreted drug; used to treat
    ulcers caused by H.pylori bacteria and also for heartburn (OTC drug) B. esomeprazole
    (Nexium) - longer-acting drug; NOT broken down as fast in the liver
    - for treatment of GERD, severe erosive esophagitis and other hypersecretory conditions

    Actions and indications


    - for short-term treatment of active duodenal ulcers, GERD, erosive esophagitis and
    benign active gastric ulcer
    - for long-term treatment of pathological hypersecretory conditions
    - also for combination with amoxicillin and clarithromycin for treatment of H. pylori
    infection

    Contraindications and cautions


    - allergy, pregnancy or lactation

    Adverse effects
    CNS - dizziness and headache, sometimes asthenia (loss of strength), vertigo, insomnia,
    apathy
    GI - diarrhea, abdominal pain, nausea, vomiting, dry mouth and tongue atrophy
    Upper resp. tract - cough, stuffy nose, hoarseness and epistaxis

    IV. Laxatives
    - also called cathartic drugs - spped the passage of intestinal contents through the GI tract

    A. Chemical stimulants - directly stimulate nerve plexus in intestinal wall causing


    increased movement and stimulation of local reflexes

    Drugs
    1. senna (Senokot) - may have slow or steady effect or may cause severe cramping 2.
    castor oil - for thorough evacuation of intestine ; works at beginning of small intestine and
    increases motility throughout the GI tract; blocks fat absorption may lead to constipation
    3. bisacodyl (Dulcolax) - ofetn the drug of choice to empty the bowel pre-surgery or
    diagnostic tests such as barium enema, oral or rectal

    B. Bulk stimulants - rapid-acting, aggressive which increase motility of GI tract by


    incrasing fluid in intestinal contents

    Drugs
    1. magnesium sulfate (Epsom salts) - acts by exerting a hypertonic pull against mucosal
    wall, drawing fluid into intestinal contents; can be used for GI poisoning 2. magnesium
    hydroxide (Milk of Magnesia) - to stimulate bulk and is milder and slower-acting; also
    works by saline pull
    3. lactulose (Chronulac) - alternative choice for clients with cardiovascular problems;
    saltless osmotic laxative pulls fluid out of venous system 4. psyllium (Metamucil) -
    gelatin-like bulk stimulant - milder and less irritating

    Drugs
    Three ways:
    1. By direct chemical stimulation of GI tract
    2. By production of bulk or increased fluid in lumen of G tract
    3. By lubrication of intestinal bolus to promote passage through GI tract

    - for short-term relief of constipation and prevent straining like in post-op, MI or OB


    delivery
    - for bowel evacuation for diagnostic procedures
    - remove ingested poisons from lower GI tract
    - most are available OTC but often abused becoming dependent which can develop
    chronic intestinal disorders

    Contraindications and cautions


    - acute abdominal disorders including appendicitis, diverticulitis and ulcerative colitis
    when increased motility can lead to rupture or further exacerbation of inflammation -
    pregnancy or lactation

    Adverse effects
    GI - diarrhea, abdominal cramping and nausea
    CNS - dizziness, headache and weakness some reported sweating, palpitations, and
    flushing
    - very common is cathartic dependence

    V. Gastrointesinal stimulants
    -stimulate parasympathetic activity

    Drug
    1. Metoclopramide (Plasil, Reglan) - blocks dopamine receptors and makes GI cells more
    sensitive to acetylcholine, leading to increased GI activity and rapid movement of food
    through the upper GI tract

    - for relief of symptoms of GERD, prevent nausea and vomiting post-op and promote GI
    movement during small bowel intubation

    Actions and indications


    - do NOT have local effects of laxatives to increase activity only in intestines
    - indicated when more rapid movement of GI contents is desirable

    Contraindications and cautions


    - allergy, pregnancy or lactation

    Adverse effects
    - nausea, vomiting, diarrhe, intestinal spasm and cramping, others are declining BP and
    heart rate, weakness and fatigue

    VI. Antidiarrheal drugs


    - block stimulation of GI tract are used for symptomatic relief from diarrhea

    Drug
    1. loperamide (Imodium) - direct effect on muscle layers of GI tract to slow peristalsis
    and allow increased time for absorption of fluid and electrolytes - slowly absorbed

    Contraindications and cautions


    - allergy, pregnancy or lactation, GI obstruction, acute abdominal conditions or diarrhea
    due to poisonings

    Adverse effects
    - constipation, distention, abdominal discomfort, dry mouth

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