This document summarizes various types of gastrointestinal agents including antacids, H2 receptor antagonists, proton pump inhibitors, coating agents, anti-inflammatory agents, antidiarrheals, laxatives, antiemetics, antiflatulents, and obesity drugs. It provides information on their mechanisms of action, adverse reactions, considerations, indications, and examples of commonly used medications for each class.

1. GASTROINTESTINAL
AGENTS
ANTACIDS
moa---weak bases that react gastric HCl to form salt and
water to reduce gastic acid.
adverse reactions----constipation, diarrhea
consider----frequent doseage yields noncompliance
impairs tetracycline, OTC available
indication---gastroesophagelal reflux,duodenal ulcer
examplesaluminum hydroxide/amphojel
Al hydroxide & magnesium hydroxide/ maalox
magnesium hydroxide/milk of magnesia

2. GASTROINTESTINAL AGENTS
H2 receptor antagonists
moa----used to block the action of histamine on parietal cells
(specifically the histamine H2 receptors) in the stomach,
decreasing the production of acid by these cells.
adverse reactions----constipation, diarrhea
consider----bedtime doseage works best, low dose OTC
indication---gastric ulcer,duodenal ulcer
examplescimetidine/tagamet
ranitidine/zantac
famotidine/pepcid

3. GASTROINTESTINAL AGENTS
Proton pump inhibitor
moa---inhibit parietal cell ATP pump
adverse reactions----constipation, diarrhea
consider----possible reduced bone density,
hypertension(in studies)
indication---stomach ulcer, GERD
examplesesomeprazole/nexium
lansoprazole/prevacid
omeprazole/prilosec
pantoprazole/protonix
rabeprazole/aciphex

4. GASTROINTESTINAL AGENTS
coating agents
moa----form protective coat over gastric ulcer, binds to necrotic
tissue
consider----sucralfate requires several daily doses, do not take
with antacid at same time.
indication---gastric ulcer,duodenal ulcer
examplesalginic acid/gaviscon
carafate/sucralfate

5. GASTROINTESTINAL AGENTS
antiinflammatory agents
indication---Crohns disease/ulcerative colitis
adverse reactions------naseau, headache,vomit
consider---will bind to iron tablets, keep hydrated, yields
orange/yellow urine, makes soft contact lenses yellow.
sulfasalazine not used with sulfa and aspirin allergies.
examplesmesalamine/pentasa
sulfasalazine/azulfidine

6. GASTROINTESTINAL AGENTS
antidiarrheals
moa---similar to opioids. in the bowel peristaltic waves are
diminished; this delays passage of the fecal mass
and allows increased absorption of water
adverse reactions----constipation, drowsiness,
respiratory depression
consider----severe diarrhea yields dehydration
examplesattapulgite/kaopectate
bismuth subsalicylate/pepto bismol
loperamide/imodium AD (OTC)

7. GASTROINTESTINAL AGENTS
emollient laxative----draw water in colon for evacuation
examples--lactulose/cephulac
mineral oil
magnesium hydroxide/milk of magnesia
stimulant laxative---stimulates/irritates intestine
examples--bisacodyl/dulcolax
bulk forming laxative---increase diet fiber distends intestine
yields increased peristalsis
examples--psyllium/metamucil
methyl cellulose/fiber trim

8. GASTROINTESTINAL AGENTS
ANTIEMETICS
moa----block dopamine receptors in medulla for vomiting
adverse reactions------drowsiness
consider---phenothiazines may cause hypotension, seizures
in children.
examplesdimenhydrinate/dramamine
chlorpromazine/thorzine
meclizine/antivert
prochlorperazine/compazine
promethazine/phenergan

9. GASTROINTESTINAL AGENTS
antiflatulents
moa---reduce surface tension, yields gas released easily
indication---bloating, flatulence
examplessimethicone/gas-x, mylicon
OBESITY DRUGSadverse reactions----CNS stim, dizziness, insomnia,
hypertension, arrhythmia
consider----regulations for processing, filling, dispensing
examples--diethylpropion/tenuate
sibutramine/meridia

10. GASTROINTESTINAL AGENTS
antiflatulents
moa---reduce surface tension, yields gas released easily
indication---bloating, flatulence
examplessimethicone/gas-x, mylicon
OBESITY DRUGSadverse reactions----CNS stim, dizziness, insomnia,
hypertension, arrhythmia
consider----regulations for processing, filling, dispensing
examples--diethylpropion/tenuate
sibutramine/meridia