Matching Pairs GI, Immunomodulators and anti-inflammatories, MSK, opioidsOnline version Pharm 231: drug: indications; class: adverse effects by Amanda 1 Methylnaltrexone: Peripheral opioid antagonist for opioid-induced constipation 2 Pancrelipase: Digestive enzyme for cystic fibrosis or pancreatic insufficiency 3 Sucralfate: used for active oral, esophageal, and duodenal ulcers 4 Misoprostol: Specifically used for NSAID-induced ulcer prophylaxis 5 Loperamide: Antidiarrheal agent 6 Famotidine: (PUD), GERD, hypersecretory syndromes, and stress ulcer prophylaxis 7 Senna, Psyllium, Polyethylene Glycol (MiraLAX), & Docusate: Various forms of laxatives for the treatment of constipation (Protectant): Bone loss and hypomagnesemia (Digestive Enzymes): GI irritation (Opioid Antagonist): Diarrhea and dehydration (Antidiarrheal): Constipation (Laxatives): Diarrhea, dehydration, palpitations, and hypotension (H2 Antagonist): Bone loss, hypomagnesemia, and pneumonia (Prostaglandin): Induction of labor (Category X in pregnancy) 1 Prochlorperazine (Compazine): Management of nausea and vomiting 2 Aprepitant: Specifically for highly emetogenic chemotherapy-induced nausea and vomiting 3 Metoclopramide (Reglan): Post-operative nausea and vomiting; also a GI stimulant to promote gastric emptying 4 Pantoprazole: GERD, erosive esophagitis, stress ulcer prophylaxis, and hypersecretory syndromes 5 Lactulose: Used to decrease ammonia levels in hepatic encephalopathy 6 Ondansetron (Zofran): Gold standard for post-operative and chemotherapy-induced nausea and vomiting (Non-absorbable disaccharide): Chronic diarrhea (GI Stimulant): Tardive dyskinesia and CNS depression (Dopamine Receptor Antagonist): Tardive dyskinesia and CNS depression (Proton Pump Inhibitor): Bone loss, hypomagnesemia, and pneumonia (5-HT3 Antagonist): Serotonin syndrome and QT prolongation (Substance P/NK1 Antagonist): Decreases effectiveness of warfarin 1 Methotrexate: Rheumatoid arthritis, juvenile idiopathic arthritis, and certain cancers 2 Dexamethasone: used for allergic/inflammatory disorders and as an adjunct for chemotherapy-induced vomiting 3 Oprelvekin: Indicated for chemotherapy-induced thrombocytopenia 4 Filgrastim: Used for chemotherapy-induced neutropenia 5 Peginterferon alfa-2a: Treatment of Hepatitis B & C and certain cancers 6 Adalimumab: Rheumatoid arthritis, Crohn’s disease, ulcerative colitis, and hidradenitis suppurativa 7 Mycophenolate: Prevention of organ transplant rejection 8 Aspirin: Fever, mild pain, inflammation, and low-dose prophylaxis for MI/CVA (Colony-Stimulating Factor): Significant bone pain and GI effects (Glucocorticoid): Increased infection risk and bone marrow suppression (Interleukin): Flu-like symptoms, hypotension, arrhythmias, fluid retention, and pulmonary edema (Monoclonal Antibody): Serious infections, lymphomas, MI, and hepatotoxicity (T- and B-Cell Suppressor): Serious infections, lymphomas/cancers, demyelinating disorders, MI, HF, and pulmonary edema (Antimetabolite): Serious infections, lymphomas, MI, and nephrotoxicity (Salicylate): Bleeding, GI upset/heartburn, salicylism toxicity, and Reye’s syndrome in children (Interferon): Flu-like symptoms, bone marrow suppression, hepatotoxicity, and neuropsychiatric effects 1 Celecoxib: Osteoarthritis and rheumatoid arthritis (preferred when GI protection is needed) 2 Imatinib 3 Cetirizine: Second-generation antihistamine for allergies 4 Diphenhydramine: Allergy, motion sickness, insomnia, and the common cold 5 Tamoxifen 6 Cisplatin, Fluorouracil, & Etoposide: 7 Acetaminophen: Relief of mild pain and fever 8 Ibuprofen: Fever, acute pain, dysmenorrhea, and arthritis Chemotherapy agents for various neoplasms (Non-opioid Analgesic): Hepatotoxicity Targeted therapy for specific tumor cells Estrogen receptor-positive breast cancer (COX-2 Selective NSAID): Platelet clumping (clot risk), hypertension, and renal injury (Second-Generation Antihistamine): Minimal sedation compared to first-generation (Antihistamine): Drowsiness/sedation and anticholinergic effects (dry mouth, urinary retention) (Non-selective NSAID): Bleeding, hypertension, and renal injury 1 Allopurinol: Chronic gout management and hyperuricemia (often from chemotherapy)(always co-administered with colchicine) 2 Baclofen: Centrally-acting relaxant for muscle spasticity (e.g., MS, spinal cord injury) 3 Colchicine: Acute gout flares, familial Mediterranean fever, and acute pericarditis 4 Buprenorphine: Chronic pain and opioid use disorder 5 Calcitriol: Treatment of hypocalcemia (Vitamin D analog) and management of osteoporosis or Paget's disease 6 Naloxone (Narcan): Emergency reversal of opioid overdose 7 Dantrolene: Upper motor neuron muscle spasticity and the treatment of malignant hyperthermia 8 Morphine, Fentanyl, Oxycodone, Hydrocodone, & Tramadol: Management of moderate to severe pain 9 Alendronate: Osteoporosis and Paget's disease 10 Calcitonin salmon: Osteoporosis and Paget’s disease (Xanthine Oxidase Inhibitor): Hypersensitivity reactions and renal/hepatic dysfunction, acute gout flares with start of tx (Anti-inflammatory Agent): Potentially fatal GI toxicity, bone marrow suppression, and rhabdomyolysis (Antihypocalcemic/Vit D): Hypercalcemia and CNS effects (weakness, irritability) (Opioid Agonist-Antagonist): Respiratory depression (at very high doses) and GI distress (Opioid Agonists): Respiratory depression, sedation, constipation, orthostatic hypotension, and physical dependence (Bisphosphonate): Esophageal ulceration, bone pain, and osteonecrosis of the jaw (Direct-Acting Muscle Relaxant): Direct hepatocellular damage and CNS depression (Opioid Antagonist): Acute opioid abstinence syndrome (Calcitonin): Nasal dryness, flushing/rash, and urinary frequency (Centrally-Acting Muscle Relaxant): CNS depression (drowsiness, weakness)
