Pocket Guide to GastrointestinaI Drugs

Michael Wolfe, M.D is a former Chair of the FDA's advisory board for gastrointestinal drugs. He has achieved significant recognition for his interest in acid-related disorders, specifically GERD, NSAID-associated gastroduodenal ulcers, gastrinoma and other neuroendocrine tumors. He is on the editorial boards of Digestive Diseases and Sciences and Regulatory Peptides, and served as a member of the editorial board of The American Journal of Physiology. He has edited several textbooks, including Therapy of Digestive Disorders and Heartburn: Extinguishing the Fire Inside. In total, he's authored over 300 articles, chapters, abstracts and reviews. Robert C. Lowe, M.D. is the author of numerous book chapters and articles, and is co-editor of Educational Review Manual in Gastroenterology and GI Emergencies: A Quick Reference Guide. For the past 4 years, he has served as the chairman of the Medical Advisory Committee of the American Liver Foundation, New England Chapter and he is currently serving as a member of the Education and Training Committee of the American Gastroenterological Association.

List of contributors, xi Preface, xvi PART I: UPPER GI TRACT 1 Prokinetic agents and antiemetics, 3 Hemangi Kale and Ronnie Fass Prokinetics, 3 Antiemetic agents, 7 Recommended reading, 14 2 Proton pump inhibitors, 15 Wanda P. Blanton and M. Michael Wolfe Introduction, 15 Mechanism of action, pharmacodynamics, kinetics, 15 Clinical use and dosing, 18 Adverse effects/safety, 27 Recommended reading, 28 3 Histamine H2-receptor antagonists, 31 Kentaro Sugano Introduction, 31 Mechanism of action, 31 Pharmacology, 33 Clinical effectiveness, 40 Adverse events, 41 Recommended reading, 42 4 Prostaglandins and other mucosal protecting agents, 44 Carlos Sostres and Angel Lanas Introduction of drug class, 44 Physicochemical properties, 45 Formulations and recommended dosages, 46 Mechanism of action, 47 Drug interactions, 48 Pharmacokinetics, 49 Clinical effectiveness, 49 Toxicity, 51 Pregnancy classes, 52 Other mucosal protecting agents, 52 Recommended reading, 54 PART II: SMALL AND LARGE INTESTINE 5 5-HT modulators and other antidiarrheal agents and cathartics, 59 Albena Halpert and Douglas Drossman Introduction, 59 5-HT modulators used in the management of GI disorders, 59 5-HT agents approved in the US for specific GI indications, 60 Medications used for the treatment of chronic constipation, 71 Medications used for the treatment of narcotic-induced constipation, 76 Antidiarrheal agents, 76 Conclusion, 80 Recommended reading, 80 6 5-aminosalicylates, 82 Hannah L. Miller and Francis A. Farraye Introduction, 82 Preparations, 82 Clinical use and efficacy, 84 Pharmacology: preparations and dosing, 87 Mechanism of action, 89 Bioavailability and metabolism, 89 Adverse effects and toxicity, 91 Pregnancy, 93 Drug interactions (package inserts), 94 Precautions and contraindications, 94 Special considerations: effectiveness in colorectal cancer prevention, 96 Conclusion, 97 Recommended reading, 97 7 Immunosuppressive agents, 100 Lev Lichtenstein and Gerald M. Fraser Introduction, 100 Thiopurines, 100 Low-dose methotrexate (MTX), 106 Calcineurin inhibitors, 111 Recommended reading, 114 8 Biological agents, 117 Gert Van Assche Biological agents approved to treat IBD, 117 Optimal treatment strategies with anti TNF therapies in IBD, 119 Safety of biological agents in IBD, 120 Emerging biologicals, 121 Recommended reading, 121 PART III: LIVER AND PANCREAS 9 Interferons, 125 Robert C. Lowe Introduction, 125 Mechanism of action, 125 Pharmacology, 126 Clinical effectiveness, 127 Toxicity, 128 Interferon types with generic and brand names, 129 Pregnancy classes, 130 Initial interferon dosing regimens for chronic hepatitis C, 130 Recommended reading, 131 10 Nucleoside analogs, 133 Uri Avissar and David P. Nunes Introduction, 133 Mechanism of action, 135 Pharmacology, 137 Clinical effectiveness, 139 Nucleoside analogs, 141 Nucleotide analogs, 146 Summary, 147 Recommended reading, 148 11 Ursodeoxycholic acid, chelating agents, and zinc in the treatment of metabolic liver diseases, 150 Andrew K. Burroughs and James S. Dooley Ursodeoxycholic acid, 150 Treatment of copper overload, 155 Recommended reading, 162 12 Agents for the treatment of portal hypertension, 165 Karen L. Krok and Andres Cardenas Introduction, 165 Nonselective beta-blockers (NSBB), 166 Nitrates, 169 Vasopressin analogs, 169 Somatostatin analog, 170 Midodrine, 171 Albumin, 172 Loop diuretics, 172 Aldosterone antagonist, 174 Aquaretics, 174 Disaccharides, 175 Antibiotics, 176 Recommended reading, 177 13 Pancreatic enzymes, 179 Steven J. Czinn and Samra S. Blanchard Introduction, 179 Mechanism of action, 180 Dosing and schedule of administration, 180 Monitoring therapy, 183 Adverse effects, 183 Recommended reading, 184 PART IV: ANTIMICROBIALS AND VACCINES 14 Antibiotics for the therapy of gastrointestinal diseases, 187 Melissa Osborn Introduction, 187 Pharmacologic properties, 187 Clinical uses, 195 Recommended reading, 202 15 Antimicrobials for parasitic diseases, 204 Joachim Richter 5-Nitroimidazoles, 204 Benzimidazoles, 206 Ivermectin, 211 Praziquantel, 212 Treatment dosages, 214 Recommended reading, 216 16 Vaccines for viral hepatitides, 219 Savio John and Raymond T. Chung Hepatitis A vaccination, 219 Hepatitis B vaccination, 222 Recommended reading, 227 17 Rotavirus and other enteric vaccinations, 229 Christopher J. Moran and Esther J. Israel Rotavirus vaccination, 229 Typhoid fever vaccination, 232 Recommended reading, 233 PART V: NUTRITION AND PROBIOTICS 18 Parenteral and enteral nutrition feeding formulas, 237 Dominic N. Reeds and Beth Taylor Introduction, 237 Indications for nutrition support, 237 Energy and macronutrient requirements, 237 Protein, 238 Carbohydrate, 239 Lipids, 239 Enteral liquid feeding formulations, 239 Disease-specifi c formulas, 244 Selection of an appropriate enteral formula, 245 Implementation of enteral nutrition, 245 Parenteral nutrition, 245 Summary, 247 Recommended reading, 247 19 Probiotics, 249 Christina M. Surawicz Introduction, 249 Pharmacology, 250 Mechanisms of action, 251 Clinical indications, 251 Safety/toxicity, 255 Summary, 255 Recommended reading, 256 Index, 259