Digestants & Drugs Affecting Gallbladder Promote the process of digestion in GI tract pancrealipase (Pancrease) - contains digestive enzymes Side effect: nausea, abd. cramps, & loose stools Take before or with meals ursodiol (Actigall) dissolves radiolucent noncalcified gallstones Side effect: N & V

Antacids Drugs that buffer, neutralize or absorb hydrochloric acid in the stomach Should be taken 1 hour after meals & @ bedtime Watch for drug interactions Magnesium (MOM) - diarrhea Aluminum carbonate (Amphojel) - constipation Maalox (aluminum hydroxide with & magnesium)

Peptic Ulcer Treatment Multi-drug treatment Usually 2 antibiotics & a proton pump inhibitor or histamine blocking agent & then add bismuth subsalicylate - Pepto-Bismol

Cytoprotective Agents Sucralfate (Carafate) – tx duodenal ulcer forms a protective, acid-resistant shield in the ulcer crater give one hour before meals & at bedtime Do Not Chew the Tablet Administer antacids within 30 minutes before or after Side effect: constipation

Proton Pump Inhibitors Blocks the final step of acid production – decreases acid production lansoprazole (Prevacid): side effect/diarrhea omeprazole (Prilosec): side effect/diarrhea & headache Swallow capsule whole & take before meals Tx GERD, gastric ulcer, H. pylori

H2 Receptor Antagonists Activation of H2 receptors increases gastric acid secretion so these drugs block this activation cimetidine (Tagamet) – tx peptic & duodenal ulcer, GERD, hypersecretory conditions – generally well tolerated drug ranitidine (Zantac) famotidine (Pepcid) nizatidine (Axid)

Antiflatulents Simethicone (Mylicon) Defoaming agent- causes gas bubbles to unite Relieves flatulence by dispensing and preventing the formation of mucus-surrounded gas pockets in the GI tract

Gastrointestinal Stimulant Increases ACH – increases peristalsis – tx diabetic gastric stasis antiemetic Metoclopramide (Reglan) AE – drowsiness & depression & Parkinson-like symptoms When to give

Antiemtics Prevent or relieve N & V, used with chemotherapy & postop May exert effect on vomiting center, cerebral cortex, chemoreceptors trigger zone or vestibular apparatus Side effect: headache, constipation & malaise ondansetron hydrochloride (Zofran)

Laxatives Do not give with undiagnosed abdominal pain Better to treat with increase fluids, vegetables, fruits & bran products Laxative abuse Saline (MOM) Stimulant (Dulcolax, Ex-Lax) Bulk Forming (Metamucil)

Laxatives (cont.) Lubricant (Mineral Oil) Stool Softener (Colace) Hyperosmotic (Lactulose & GoLYTELY)

Antidiarrheal Agents Adsorbents: coats wall of GI tract, absorb bacteria or toxins causing the diarrhea & passing then out with stool (Kaopectate) Pepto-Bismol - promotes absorption of fluids & has antimicrobial effect diphenoxylate HCL with Atropine (Lomotil), “synthetic narcotic”, meperedine