Gi Cocktail Recipe With Benadryl

TOC |DRUGS | GI

GI Drugs

H2 Antigonist Drugs for PUD/ Gastritis

Pepcid (Famotidine) 20-40 mg tab, 40 mg/5ml suspension. Dose 20 mg bid or 40 mg hs
Tagamet (Cimetidine) 200-300-400-800 mg tab; 300 mg/5ml; IV soln. Dose 300 mg tid, 400 mg bid or 800 mg hs; 900 mg/d IV infusion
Zantac (Ranitidine) 150-300 mg tab; 75 mg/5ml syrup. Dose 150 mg bid or 300 mg hs; 50 mg q6 8h IVPB
Axid (nizatidine) 150 mg tablet. Dose 150 mg bid or 300 mg hs

GI cocktail of 10-15 ml 1% viscous lidocaine and 15-30 mL antacid has been suggested to rule out esophageal pain, but positive response does not clearly rule out cardiac pain

Proton Pump Inhibitors:

Protonix® (Pantoprazole ) 40 mg tab 1-2x/day PO or 80 mg q12h IV
Prilosec® (Omeprazole) 10-20 mg tab 1-2x/day
Prevacid® (Lansoprazole) 15-30 mg cap QD
Aciphex® (Rabeprazole) 20 mg tab once daily
Nexium® (Esomeprazole) capsule 20 or 40 mg cap once/day

Anti Helicobacter pylori Rx:
The following 3-drug regimen given for ONE WEEK is recommended as first-line therapy for eradication of H.pylori in patients who test positive:

- Amoxicillin 1 gram BID (#28 x 500mg), plus
(may use Metronidazole/Flagyl 500 mg BID if amoxicillin is not tolerated)
- Clarithromycin (Biaxin) 500 mg BID (#14 x 500mg), plus
- Omeprazole (Prilosec) 20 mg BID or Pantoprazole (Protonix) 40 mg BID (#14 x 40mg)

Omeprazole 20 mg + Flagyl 500 mg + Clarithromycin 250 mg BID x 10 days
Peptobismuth 2 tab qid + tetracycline 500 mg qid (or Amoxicillin 500 mg qid) + Flagyl 250 mg qid x 2 wks.

Campylobacter jejuni Rx:

Cipro 500 mg bid x 5 days, or
Azithromycin 500 mg daily x 3 days, or
Erythromycin 500 mg qid x 5 days

Clostridium difficile Rx:

Metronidazole (Flagyl) 250 mg qid or 500 mg tid PO or IV for 7-10 days, or
Vancomycin 125 mg qid PO for 8-10 days

Anti-emetics

Compazine/Prochlorperazine 5-10 mg q8h PO or IM or IV slowly; 25 mg rectal suppository
Tigan/Trimethobenzamide 100-250 mg cap PO or 200 mg IM 3-4x/d; 200 mg rectal suppository
Reglan/Metoclopramide 10-15 mg 3-4x/d PO or IM or IV.
Vistaril/Hydroxyzine 25-100 mg PO, IM or IV
Phenergan/Promethazine 25 mg PO or IM, or supp. q4h
Benadryl/Diphenhydramine 25-50 mg PO, IM or IV
Zofran/Ondansetron 4-8 mg tab PO q8h, or 32 mg (or 0.15 mg/kg) IV infusion over 15 min q4-8h.
Scopolamine 0.1 mg IV or Transderm-Scop skin-patch q 72 h
Kytril/Granisetron 10 ug/kg IV over 5 min once/day
Cannabinoids as Marinol/dronabinol
Corticosteroid in combination with other antiemetics may be effective.
Inapsine (Droperidol) 0.625 - 1.25 mg IM or IV q 3-4 h prn (Caution prolonged QT interval)
Anzemet (Dolasetron) 100 mg PO daily prn
Propulsid/Cisapride 10-20 mg tab ac & hs - discontinued !

Anti-Spasmotic Rx:

Bentyl (Dicyclomine) 10-20 mg qid
Donnatal (Phenobarbital-hyoscyamine-atropine-scopolamine) 1-2 tab 3-4x/day
Donnatal Extentab 1 tab bid
Librax (Librium-chlordiazepoxide/clidinium) 1-2 cap 3-4x/day
Levsin (Hyoscyamine) 0.125 - 0.25 mg q4h
Levbid (Hyoscyamine) 0.375 mg bid

Drugs for Constipation:

Fluid & High fibers as Metamucil or Citrucil powder
Laxatives -osmotic:
- Miralax (Polyethylene glycol) powder 1 tablespoon in 8 oz fluid/day
- Lactulose 1-2 oz tid prn
- Sorbitol
Amitiza (Lubiprostone)
- for adult with chronic idiopathic constipation 24 mcg capsule twice daily PO.
Laxatives - stimulant:
- Bisacodyl (Dulcolax, Correctol) 5-10 mg PO daily prn; OTC 5 mg tab or 10 mg supp.
- Cascara OTC 325 mg tab PO qhs prn or liquid
- Castor oil 15 -30 mL PO prn
- Senna (Senokot, Ex-Lax) 1 tsp or 2 tab PO prn PO
- Lubiprostone (Amitiza) 24 mcg cap bid with meals prn constipation.

Drugs for Irritable Bowel Syndrome (IBS)

Zelnorm (Tegaserod) 6 mg tab bid before meal for Irritable Bowel Syndrome constipation
- Warning: significant diarrhea with hypovolemia, hypotension & rare ischemic colitis may occur!
Amitiza (lubiprostone) 24 mcg BID with food - for chronic idiopathic constipation
Lotronex (Alosetron) 1 mg tab bid - NOT RECOMMENDED !!
- a potent selective serotonin receptor (5-HT₃) antagonist that reduces pain & hypermotility.
- s ome reported severe constipation & ischemic colitis (Warnings! )

Anti-emetics:

**Anti-Emetic Medications**
Type of Nausea	Useful Drug Class	Example of Drugs
Vestibular or Inflammation/ infection	Anticholinergics Antihistamines	Phenergan (Promethazine) 12.5 - 25 mg PO a4h prn Transdrm-Scop (Scopolamine) 1 patch q 72 h, Tigan (Trimethobenzamide) 250 mg PO q6-8h
Dysmotility	Prokinetics	Reglan (Metoclopramide) 5-20 mg PO q 6-12 h prn
Toxins as opioids, etc.	Antidopaminergics 5-HT3 Antagonists	Compazine (Prochlorperazine) 5-10 mg PO q 6-8 h prn Inapsine (Droperidol) 0.625 - 1.25 mg IM or IV q 3-4 h prn (Caution prolonged QT interval) Anzemet (Dolasetron) 100 mg PO daily prn Zofran (Ondansetron) 8 mg PO 2-3x/day prn

2009