GI Medications
GI Medications
Proton Pump Inhibitors (PPIs)
- Examples: Omeprazole (Prilosec), Pantoprazole (Protonix), Esomeprazole (Nexium), Lansoprazole (Prevacid)
- Purpose: Reduces gastric acid production.
- Uses: GERD, peptic ulcer disease (PUD), Zollinger-Ellison syndrome, H. pylori infection (as part of triple therapy).
- Warnings: Long-term use risks include fractures, B12 deficiency, and C. difficile infection.
- Contraindications: Hypersensitivity to PPIs.
- Additional Note: Take 30 minutes before the first meal of the day.
H2-Receptor Antagonists (H2 Blockers)
- Examples: Ranitidine (Zantac), Famotidine (Pepcid), Cimetidine (Tagamet)
- Purpose: Decrease stomach acid by blocking histamine receptors.
- Uses: GERD, mild PUD, heartburn relief.
- Warnings: Cimetidine has many drug interactions; use with caution in elderly patients.
- Contraindications: Severe renal impairment without dose adjustment.
- Additional Note: Often taken at bedtime for nocturnal acid suppression.
Antacids
- Examples: Calcium carbonate (Tums), Magnesium hydroxide (Milk of Magnesia), Aluminum hydroxide (Amphojel)
- Purpose: Neutralize stomach acid.
- Uses: Heartburn, indigestion, sour stomach.
- Warnings: Magnesium-based antacids can cause diarrhea; calcium-based ones may increase kidney stone risk.
- Contraindications: Severe renal impairment, hypercalcemia.
- Additional Note: Take 1-2 hours before or after other medications
Prokinetic Agents
- Example: Metoclopramide (Reglan)
- Purpose: Enhances GI motility and gastric emptying.
- Uses: Gastroparesis, GERD, nausea related to delayed gastric emptying.
- Warnings: Risk of tardive dyskinesia; may cause drowsiness.
- Contraindications: GI obstruction, Parkinson’s disease.
- Additional Note: Usually given before meals.
Antiemetics
- Examples:
- Serotonin Antagonists: Ondansetron (Zofran)
- Dopamine Antagonists: Prochlorperazine (Compazine), Promethazine (Phenergan)
- Purpose: Prevent or relieve nausea and vomiting.
- Uses: Postoperative, chemotherapy-induced, and gastroenteritis nausea.
- Warnings: Ondansetron may cause QT prolongation.
- Contraindications: Ondansetron: QT prolongation.
- Additional Note: Watch for extrapyramidal symptoms with dopamine antagonists.
Antidiarrheals
- Examples: Loperamide (Imodium), Diphenoxylate/Atropine (Lomotil)
- Purpose: Slow intestinal motility to reduce stool frequency.
- Uses: Acute and chronic diarrhea relief.
- Warnings: Toxic megacolon risk with infectious colitis; loperamide overdose can cause arrhythmias.
- Contraindications: Bacterial enterocolitis, pseudomembranous colitis.
Laxatives and Stool Softeners
- Examples:
- Bulk-forming: Psyllium (Metamucil)
- Osmotic: Polyethylene glycol (MiraLAX), Lactulose
- Stimulant: Bisacodyl (Dulcolax), Senna
- Stool Softener: Docusate sodium (Colace)
- Purpose: Facilitate bowel movements through various mechanisms.
- Uses: Constipation, bowel prep, opioid-induced constipation.
- Warnings: Bulk-forming laxatives require adequate fluid intake.
- Contraindications: GI obstruction, undiagnosed abdominal pain.
- Additional Note: Take with water to avoid obstruction.
Bismuth Subsalicylate
- Example: Pepto-Bismol
- Purpose: Anti-inflammatory, antimicrobial, and acid-neutralizing effects.
- Uses: Diarrhea, indigestion, H. pylori infection.
- Warnings: May cause black stool/tongue; risk of Reye’s syndrome in children.
- Contraindications: Salicylate allergy, bleeding disorders.
- Additional Note: Avoid in children with viral infections.
Corticosteroids (for GI Inflammatory Conditions)
- Examples: Prednisone, Budesonide (Entocort)
- Purpose: Potent anti-inflammatory action.
- Uses: Exacerbations of Crohn’s disease, ulcerative colitis.
- Warnings: Long-term use may cause osteoporosis, hyperglycemia.
- Contraindications: Systemic fungal infections.
- Additional Note: Short-term use for flare-ups; taper to avoid adrenal suppression.