Updated: 12/31/2021

Gastrointestinal Medications

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  • Gastrointestinal Drug┬áIntroduction
    • Gastrointestinal medications can be broken down into the following categores
      • antidiarrheals
      • antiemetics
      • H2 antagonists
      • proton pump inhibitors
      • other antiulcer medications
      • laxitives
  • Gastrointestinal Drug Table
    • Antidiarrheals
        • Name
        • Mechanism of Action
        •  Key Indication
        •  Key Toxicity
        • Lomotil (diphenoxylate + atropine)
        • Opioid agonist + anti-muscarinic
        • Diarrhea
        • Constipation
        •  Dry eyes, mouth, skinv
        •  Urinary retention
        • Loperamide
        • Opioid agonist
        • Diarrhea
        • Constipation
    • Antiemetics
        • Name
        • Mechanism of Action
        •  Key Indication
        •  Key Toxicity
        • Dimenhydrinate
        • 1st generation antihistamine
        • Nausea/Vomiting
        •  Vertigo (ondansetron)
        •  Gastroprokinetic (metoclopramide)
        •  Motion sickness (scopolamine)
        • Sedation
        •  Orthostatic hypotension
        •  Dry eyes, mouth
        • Ondansetron
        • 5-HT3 antagonist
        • Nausea/Vomiting
        • Vertigo (ondansetron)
        • Gastroprokinetic (metoclopramide)
        • Motion sickness (scopolamine)
        • Headache
        •  Torsades
        •  QT prolongation
        •  Constipation
        • Prochlorperazine
        • D2 antagonist
        • Nausea/Vomiting
        • Vertigo (ondansetron)
        • Gastroprokinetic (metoclopramide)
        • Motion sickness (scopolamine)
        • Dystonia
        •  Parkinsonism
        •  Akathisia
        •  EPS
        • Metoclopramide
        • Central D2 + 5-HT3 antagonists
        •  Peripheral 5-HT4 agonist
        • Nausea/Vomiting
        • Vertigo (ondansetron)
        • Gastroprokinetic (metoclopramide)
        • Motion sickness (scopolamine)
        • Parkinsonian symptoms
        •  EPS
        • Scopalamine 
        • Muscarinic antagonist
        • Nausea/Vomiting
        • Vertigo (ondansetron)
        • Gastroprokinetic (metoclopramide)
        • Motion sickness (scopolamine)
        • Sedation
        • Promethazine
        • 1st generation antihistamine
        •  ╬▒-antagonist
        •  Anti-cholinergic properties
        • Nausea/Vomiting
        • Vertigo (ondansetron)
        • Gastroprokinetic (metoclopramide)
        • Motion sickness (scopolamine)
        • Sedation
        •  Dry mouth, eyes
        •  Dystonia
        •  Parkinsonism
        •  Akathisia
        •  EPS
    • H2 Antagonists
        • Name
        • Mechanism of Action
        •  Key Indication
        •  Key Toxicity
        • Cimetadine
        • H2 blocker
        • Gastritis/GERD
        • Anti-androgen
        • P450 inhibitor
        •  Decreased creatinine clearance
        • Famotidine
        • H2 blocker
        • Gastritis/GERD
        • Sedation
        • Ranitidine 
        • H2 blocker
        • Gastritis/GERD
        • Decreased creatinine clearance
    • Proton Pump Inhibitors
        • Name
        • Mechanism of Action
        •  Key Indication
        •  Key Toxicity
        • Lansoprazole
        • Omeprazole
        • Irreversible parietal H+/K+ ATPase inhibition
        • Gastritis/GERD
        • P-450 inhibition 
        •  Increased risk of C. diff infection
        •  B12 and Mg2+ deficiency
    • Other Anti-Ulcer
        • Name
        • Mechanism of Action
        •  Key Indication
        •  Key Toxicity
        • Simethicone
        • Coating agent
        •  Decreases surface tension of gas bubbles (simethicone)
        • Gastric
        • GI symptoms
        • Sucralfate
        • Carafate
        • Coating agent
        •  Decreases surface tension of gas bubbles (simethicone)
        • Gastric
        • Constipation
        •  Flatulence
        •  Headache
    • Laxatives
        • Name
        • Mechanism of Action
        •  Key Indication
        •  Key Toxicity
        • Bulk-forming laxatives
        • (psyllium, methylcellulose, fiber supplements)
        • Bulk-forming
        •  Draws in water to gut lumen
        • Constipation
        • Bloating
        • Osmotic laxatives
        • (magnesium hydroxide, magnesium citrate, polyethylene glycol) 
        • Increases osmotic load in gut lumen drawing in water
        • Constipation
        • Decreased deep tendon reflexes (Mg2+)
        •  Diarrhea
        •  Alkalosis
        • Stimulant laxatives
        • (senna, bisacodyl)
        • Stimulates enteric nerves causing colonic contraction
        • Constipation
        • Diarrhea
        • Emollient laxatives
        •  (mineral oil, docusate)
        • Osmotic draw into gut lumen
        • Constipation
        • Diarrhea
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