Pocket Guide to GastrointestinaI Drugs E-Book

• Herausgeber: John Wiley & Sons
• Kategorie: Fachliteratur
• Sprache: Englisch

Seitenzahl: 352

Veröffentlichungsjahr: 2014

Beschreibung

Learn all you need to know about gastrointestinal drugs and their clinical use with this one-stop, rapid reference pocket guide.

Brought to you by many of the world's leading GI drug experts, Pocket Guide to Gastrointestinal Drugs provides comprehensive guidance to the pharmacological properties of drugs used to treat gastrointestinal conditions, including mechanisms of action, appropriate administration, and potential adverse effects associated with their use.

Organized by class of drug and ranging from PPIs to immunosupressants, each chapter first examines the specific agents within that class and then their appropriate and judicious use across a range of specific GI disorders.

Key features include:

• Introduction of drug class
• Basic pharmacology, including mechanism of action, bioavailability, metabolism, interactions, adverse effects, toxicity, and special considerations
• Dosing information for each GI condition and on- and off-label use
• Consistent use of both generic and trade names throughout
• Specific reference to drug use in pediatric patients and during pregnancy

Perfect for quick consultation on the wards and in the office, Pocket Guide to Gastrointestinal Drugs is the ideal tool for all those managing patients with GI conditions, including gastroenterologists, GI trainees, emergency physicians, GI specialist nurses, primary care physicians and residents, intensivists and pharmacists.

Leseprobe

Contents

Cover

Title Page

Copyright

List of contributors

Preface

PART I: UPPER GI TRACT

Chapter 1: Prokinetic agents and antiemetics

Prokinetics

Antiemetic agents

Recommended reading

Chapter 2: Proton pump inhibitors

Introduction

Mechanism of action, pharmacodynamics, kinetics

Clinical use and dosing

Adverse effects/safety

Recommended reading

Chapter 3: Histamine H2-receptor antagonists

Introduction

Mechanism of action

Pharmacology

Clinical effectiveness

Adverse events

Recommended reading

Chapter 4: Prostaglandins and other mucosal protecting agents

Introduction of drug class

Physicochemical properties

Formulations and recommended dosages

Mechanism of action

Drug interactions

Pharmacokinetics

Clinical effectiveness

Toxicity

Pregnancy classes

Other mucosal protecting agents

Recommended reading

PART II: SMALL AND LARGE INTESTINE

Chapter 5: 5-HT modulators and other antidiarrheal agents and cathartics

Introduction

5-HT modulators used in the management of GI disorders

5-HT agents approved in the US for specific GI indications

Medications used for the treatment of chronic constipation

Medications used for the treatment of narcotic-induced constipation

Antidiarrheal agents

Conclusion

Recommended reading

Chapter 6: 5-aminosalicylates

Introduction

Preparations

Clinical use and efficacy

Pharmacology: preparations and dosing

Mechanism of action

Bioavailability and metabolism

Adverse effects and toxicity

Pregnancy (Table 6.7)

Drug interactions (package inserts)

Precautions and contraindications (Table 6.8)

Special considerations: effectiveness in colorectal cancer prevention

Conclusion (Table 6.9)

Recommended reading

Chapter 7: Immunosuppressive agents

Introduction

Thiopurines

Low-dose methotrexate (MTX)

Calcineurin inhibitors

Recommended reading

Chapter 8: Biological agents

Biological agents approved to treat IBD

Optimal treatment strategies with anti TNF therapies in IBD

Safety of biological agents in IBD

Emerging biologicals

Recommended reading

PART III: LIVER AND PANCREAS

Chapter 9: Interferons

Introduction

Mechanism of action

Pharmacology

Clinical effectiveness

Toxicity

Interferon types with generic and brand names

Pregnancy classes

Initial interferon dosing regimens for chronic hepatitis C

Recommended reading

Chapter 10: Nucleoside analogs

Introduction

Mechanism of action

Pharmacology

Clinical effectiveness

Nucleoside analogs

Nucleotide analogs

Summary

Recommended reading

Chapter 11: Ursodeoxycholic acid, chelating agents, and zinc in the treatment of metabolic liver diseases

Ursodeoxycholic acid

Treatment of copper overload

Recommended reading

Chapter 12: Agents for the treatment of portal hypertension

Introduction

Nonselective beta-blockers (NSBB)

Nitrates

Vasopressin analogs

Somatostatin analog

Midodrine

Albumin

Loop diuretics

Aldosterone antagonist

Aquaretics

Disaccharides

Antibiotics

Recommended reading

Chapter 13: Pancreatic enzymes

Introduction

Mechanism of action

Dosing and schedule of administration

Monitoring therapy

Adverse effects

Recommended reading

PART IV: ANTIMICROBIALS AND VACCINES

Chapter 14: Antibiotics for the therapy of gastrointestinal diseases

Introduction

Pharmacologic properties

Clinical uses

Recommended reading

Chapter 15: Antimicrobials for parasitic diseases

5-Nitroimidazoles

Benzimidazoles

Ivermectin

Praziquantel

Treatment dosages (Table 15.3)

Recommended reading

Chapter 16: Vaccines for viral hepatitides

Hepatitis A vaccination

Hepatitis B vaccination (Table 16.1)

Recommended reading

Chapter 17: Rotavirus and other enteric vaccinations

Rotavirus vaccination

Typhoid fever vaccination

Recommended reading

PART V: NUTRITION AND PROBIOTICS

Chapter 18: Parenteral and enteral nutrition feeding formulas

Introduction

Indications for nutrition support

Energy and macronutrient requirements

Protein

Carbohydrate

Lipids

Enteral liquid feeding formulations

Disease-specific formulas

Selection of an appropriate enteral formula

Implementation of enteral nutrition

Parenteral nutrition

Summary

Recommended reading

Chapter 19: Probiotics

Introduction

Pharmacology

Mechanisms of action

Clinical indications (Table 19.2)

Safety/toxicity

Summary

Recommended reading

Index

This edition first published 2014 © 2014 by John Wiley & Sons, Ltd.

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Library of Congress Cataloging-in-Publication Data

Pocket guide to gastrointestinai drugs / edited by M. Michael Wolfe, Robert C. Lowe.

 p. ; cm.

 Includes bibliographical references and index.

 ISBN 978-1-118-48157-8 (paperback)

 I. Wolfe, M. Michael, editor of compilation. II. Lowe, Robert C., 1966- editor of compilation.

 [DNLM: 1. Gastrointestinal Agents–therapeutic use–Handbooks. 2. Gastrointestinal Agents–pharmacology–Handbooks. 3. Gastrointestinal Diseases–drug therapy–Handbooks. QV 39]

 RM365

 615.7′3–dc23

 2013041991

A catalogue record for this book is available from the British Library.

Wiley also publishes its books in a variety of electronic formats. Some content that appears in print may not be available in electronic books.

Cover image: iStock #10849434 © Mordolff

Cover design by Meaden Creative

List of contributors

Uri Avissar, MD

Boston Medical Center

Assistant Professor of Medicine

Boston University School of Medicine

Boston, MA, USA

Samra S. Blanchard, MD

Associate Professor

Division Head, Pediatric Gastroenterology and Nutrition

University of Maryland School of Medicine

Baltimore, MD, USA

Wanda P. Blanton, MD

Assistant Professor of Medicine

Section of Gastroenterology

Boston Medical Center

Boston University School of Medicine

Boston, MA, USA

Andrew K. Burroughs, MB. BCh Hons, FEB, FEBTM, Hon DSc (Med), FRCP, FMedSci

Consultant Physician and Hepatologist

The Royal Free Sheila Sherlock Liver Centre

Royal Free London NHS Foundation Trust;

Professor of Hepatology

Institute for Liver and Digestive Health

University College London

London, UK

Andrés Cárdenas, MD, MMSc, AGAF

Faculty Member and Senior Specialist

Institute of Digestive Diseases and Metabolism

University of Barcelona

Hospital Clinic

Barcelona, Spain

Raymond T. Chung, MD

Director of Hepatology, Medicine Service

Massachusetts General Hospital;

Associate Professor of Medicine

Harvard Medical School

Boston, MA, USA

Steven J. Czinn, MD

Professor and Chair, Department of Pediatrics

University of Maryland School of Medicine

Baltimore, MD, USA

James S. Dooley, BSc, MB, BS, MD, FRCP

Emeritus Reader in Medicine

Institute for Liver and Digestive Health

University College London;

Consultant Hepatologist

The Royal Free Sheila Sherlock Liver Centre

Royal Free London NHS Foundation Trust

London, UK

Douglas Drossman, MD

Adjunct Professor of Medicine and Psychiatry

University of North Carolina;

Co-director Emeritus

University of North Carolina Center for Functional GI and Motility Disorders

Drossman Center for the Education and Practice of Biopsychosocial Care

Chapel Hill, NC, USA

Francis A. Farraye, MD, MSc

Clinical Director, Section of Gastroenterology

Boston Medical Center;

Professor of Medicine

Boston University School of Medicine

Boston, MA, USA

Ronnie Fass, MD

Professor of Medicine Care, Western Reserve University;

Director, Division of Gastroenterology and Hepatology

Head, Esophageal and Swallowing Center

MetroHealth Medical Center

Cleveland, OH, USA

Gerald M. Fraser, MD, FRCP

Associate Professor of Medicine

Director, Inflammatory Bowel Disease Unit

Division of Gastroenterology

Rabin Medical Center

Beilinson Hospital

Petah Tikva;

Sackler Faculty of Medicine

Tel-Aviv University

Tel-Aviv, Israel

Albena Halpert, MD

Assistant Professor of Medicine

Section of Gastroenterology

Boston Medical Center

Boston University School of Medicine

Boston, MA, USA

Esther Jacobowitz Israel, MD

Assistant Professor, Pediatrics Harvard Medical School;

Director, Inpatient Quality and Safety

Associate Chief, Pediatric Gastroenterology and Nutrition

Mass General Hospital for Children

Boston, MA, USA

Savio John, MBBS

Assistant Professor of Medicine

SUNY Upstate

Syracuse, NY, USA

Hemangi Kale, MD

Assistant Professor of Medicine

Case Western Reserve University;

Fellowship Program Director

Division of Gastroenterology and Hepatology

MetroHealth Medical Center

Cleveland, OH, USA

Karen L. Krok, MD

Associate Professor of Medicine

Penn State Milton S. Hershey Medical Center

Hershey, PA, USA

Angel Lanas, MD, PhD

Chair, Digestive Diseases Service

University Hospital, IIS Aragón

University of Zaragoza, CIBERehd

Zaragoza, Spain

Lev Lichtenstein, MD

Senior Physician

Inflammatory Bowel Disease Unit

Division of Gastroenterology

Rabin Medical Center

Beilinson Hospital

Petah Tikva, Israel

Robert C. Lowe, MD

GI Fellowship Director

Boston Medical Center;

Associate Professor of Medicine

Boston University School of Medicine

Boston, MA, USA

Hannah L. Miller, MD

Assistant Professor of Medicine

Section of Gastroenterology

Boston Medical Center

Boston University School of Medicine

Boston, MA, USA

Christopher J. Moran, MD

Instructor in Pediatrics

Harvard Medical School;

Assistant in Pediatrics

Mass General Hospital for Children

Boston, MA, USA

David P. Nunes, MD

Director of Hepatology

Boston Medical Center;

Associate Professor of Medicine

Boston University School of Medicine

Boston, MA, USA

Melissa Osborn, MD

Associate Professor of Medicine

Division of Infectious Diseases

MetroHealth Medical Center

Case Western Reserve University

Cleveland, OH, USA

Dominic N. Reeds, MD

Assistant Professor of Medicine

Division of Geriatrics and Nutritional Science

Washington University School of Medicine

St. Louis, MO, USA

Joachim Richter, MD

Adjunct Professor of Tropical Medicine

University Hospital for Gastroenterology, Hepatology and Infectious Diseases

Heinrich-Heine-University

Düsseldorf, Germany

Carlos Sostres, PhD

Research Faculty

Digestive Disease Service

University Hospital, IIS Aragón

Zaragoza, Spain

Kentaro Sugano, MD

Chief Professor, Division of Gastroenterology

Department of Medicine

Jichi Medical University

Shimotsuke, Tochigi, Japan

Christina M. Surawicz, MD

Professor of Medicine

Department of Medicine

Division of Gastroenterology

Washington University School of Medicine

Seattle, WA, USA

Beth Taylor MS, RD, CNSC, FCCM

Nutrition Support Specialist

Barnes-Jewish Hospital

St. Louis, MO, USA

Gert Van Assche, MD, PhD

Professor of Medicine

University of Leuven

Leuven, Belgium;

Division of Gastroenterology

University of Toronto;

Division of Gastroenterology

Mount Sinai Hospital

Toronto, ON, Canada

M. Michael Wolfe, MD

Chair, Department of Medicine

MetroHealth Medical Center;

Charles H. Rammelkamp, Jr. Professor of Medicine

Case Western Reserve University School of Medicine

Cleveland, OH, USA

Preface

In the mid-1970s, Sir James Black developed the first H2-receptor antagonist, cimetidine, a remarkable achievement that revolutionized the treatment of acid-peptic disorders and led to the awarding of his Nobel Prize in Medicine. One year after its approval by the US Food and Drug Administration in 1977, cimetidine became the most widely prescribed drug in the world. Three other H2-receptor antagonists were subsequently marketed worldwide, and in the late 1980s, the first proton pump inhibitor omeprazole was approved for use and likewise became the most prescribed drug worldwide. Since that time, there has been a virtual explosion in the number of pharmaceutical agents available for the treatment of gastrointestinal diseases, from new biologic immunomodulators for inflammatory bowel disease to novel antiviral agents for the treatment of hepatitis B and C.

This handbook has been carefully formulated and written to provide the busy clinician with a concise, yet scholarly, review of the major classes of drugs used in the treatment of gastrointestinal and hepatobiliary disorders. Each chapter discusses the pharmacology and clinical effectiveness of classes of medications, including indications for use, dosing, and adverse events. The outstanding group of authors who have contributed their wisdom and experience represent academic centers from around the world, with contributions from Europe, Asia, and North America. The authors were selected primarily for their record of excellence as investigators, clinicians, and educators. All are engaged in clinical or basic investigation and are particularly proficient in the application of basic scientific information to the realm of patient management.

The target audience for this handbook includes gastroenterologists, gastrointestinal surgeons, and all physicians who care for patients afflicted with digestive disorders. The authors have used great care and discrimination in presenting their materials, and the subject matter has been composed in a concise, yet thorough, format. Accordingly, medical students, internal medicine, family medicine, and surgery residents, and gastroenterology fellows will view this guide as an invaluable adjunct to their educational needs, and it should be regarded as useful to the practices of emergency room and primary care physicians, hospitalists, intensivists, pharmacists, and other health care providers involved in the management of diseases of the gastrointestinal tract and hepatobiliary systems. While generic drug names are used throughout the text, each chapter also lists the international trade names for each drug to enable rapid identification of each agent.

We, the editors, dedicate this book to our colleagues and trainees, whose contributions to clinical care, research, and teaching have made our academic careers intellectually challenging and personally rewarding. We also thank Claire Brewer and Oliver Walter at Wiley, who approached the formidable task of publishing this handbook with the utmost care and who provided immeasurable assistance and advice throughout the course of formulating the content and producing the final product.

M. Michael Wolfe and Robert C. Lowe

PART: I

UPPER GI TRACT

CHAPTER 1

Prokinetic agents and antiemetics

Hemangi Kale and Ronnie Fass

MetroHealth Medical Center, Cleveland, OH, USA

Prokinetics

Introduction

Prokinetic agents enhance coordinated gastrointestinal motility by increasing the frequency and/or the amplitude of contractions without disrupting normal physiological pattern and rhythm of motility.

Acetylcholine is the principle immediate mediator of muscle contractility in the GI tract. However, most clinically useful prokinetic agents act “upstream” of acetylcholine, at receptor sites on the motor neuron itself, or even more indirectly, on neurons that are one or two orders above. Acetylcholine itself is not pharmacologically utilized because it lacks selectivity. It acts on both nicotinic and muscarinic receptors and is rapidly degraded by acetylcholinesterase. Dopamine is present in significant amounts in the GI tract and has an inhibitory effect on motility. It reduces both lower esophageal sphincter basal pressure and intragastric pressure. These effects are mediated by D receptors through suppression of acetylcholine release from myenteric motor neurons. Thus, dopamine receptor antagonists are effective prokinetic agents because of antagonizing the inhibitory effect of dopamine on myenteric motor neurons. Additionally, they act centrally on the chemoreceptor trigger zone (CTZ), thereby relieving nausea and vomiting. Presently, very few prokinetics are available in the market, primarily due to the failure of many of these compounds to demonstrate significant symptom improvement when compared with placebo in pivotal indication trials. In addition, these agents have an unacceptable safety profile. The exact reasons for the former are unknown but are believed to be related to disassociation between severity and/or frequency of symptoms and the severity or even the presence or absence of a motility abnormality.