Exam 3 — Master Medication Reference Chart (GI & Cardiology)
High-yield details, numbers, and distinguishing facts pulled from lecture notes — organized by drug class.
Pregnancy /
Medication Dose / Form Details Key Numbers & Stats High-Yield Distinguishing Fact
Monitoring
GI — H2 Blockers
Withdrawn 4/2020; reformulated version FDA- Degraded into NDMA (carcinogen) at New formulation: moisture-protected container, discard 90
Ranitidine —
approved 11/2025, Rx-only high temps — not contamination days after opening
Only other H2 blocker w/ dimethylamine
Nizatidine Standard H2 blocker dosing group; NDMA found in some lots but far Does not rapidly degrade into NDMA like ranitidine did —
less than ranitidine had
10mg & 20mg tabs OTC; 20mg chewable OTC; 40mg 14% of infants become agitated; 1% of
Famotidine Most commonly used OTC H2 blocker —
tab Rx adults get ED
Most drug interactions of the H2 blockers — most clinically
Cimetidine Standard H2 blocker dosing 4% of men develop gynecomastia —
significant class member for interactions
GI — Proton Pump Inhibitors
Omeprazole Converts to same active ingredient as AVOID with clopidogrel (Plavix) — drug interaction; use
Take on empty stomach, AM; can go BID —
(Prilosec) esomeprazole in acidic environment pantoprazole instead
Esomeprazole Same active ingredient as omeprazole Marketing implies superiority to Prilosec; pharmacologically
Take on empty stomach, AM —
(Nexium) once activated — NOT stronger equivalent
Generally preferred PPI for patients on
Pantoprazole Take on empty stomach, AM Go-to PPI when avoiding the omeprazole/Plavix interaction —
clopidogrel
Monitor
94% H+/K+ ATPase pump inhibition; 8-
Empty stomach; BID = before breakfast + before dinner Irreversible binding = no tachyphylaxis but severe rebound B12/iron/Ca/Mg
PPIs (class) week rebound acidity onset; 2-month
if PM symptoms hyperacidity; taper by halving dose q2-4wks to stop annually w/
course → up to 11-month rebound
chronic use
GI — Antacids & Protective Agents
1g = 400mg elemental calcium; separate
↑ risk hypercalcemia w/ HCTZ; avoid in recurrent Ca kidney
Calcium carbonate from
Take WITH food stones; >6mo use in males linked to arterial calcium —
(Tums/Maalox) fluoroquinolones/tetracycline/multivitamin
deposition
s/iron by 2-3 hrs
Often paired w/ magnesium antacids to offset each other's GI
Aluminum hydroxide Take AFTER meals Causes constipation —
effects
Reye syndrome risk in kids w/ viral illness (chickenpox/flu)
Bismuth subsalicylate Avoid in
Not >6 weeks daily use Salicylate-based — avoid pediatrics & pregnancy; forms black stool/tongue
(Pepto-Bismol) pregnancy
(harmless)
Best option for breakthrough sx while tapering off chronic Pregnancy
Sucralfate (Carafate) 2-4x/day, empty stomach Only 2% get constipation
PPI; not a standalone first-line Category B
Sole indication: prevent NSAID-induced ulcers in high-risk Pregnancy
Misoprostol Take WITH food ~10% get diarrhea/abdominal pain
pts; also an abortifacient — never in reproductive-age females Category X
Does NOT reduce/prevent gas production — just makes it
Simethicone (Gas-X) PRN Decreases gas bubble surface tension —
easier to pass
, Pregnancy /
Medication Dose / Form Details Key Numbers & Stats High-Yield Distinguishing Fact
Monitoring
GI — Constipation: Bulk-Forming & Stool Softeners
Husk (grainy) or hydrophilic mucilloid (fine powder) Requires adequate hydration — risk of bowel obstruction if Pregnancy
Psyllium OTC
forms dehydrated + constipated Category B
Polycarbophil Standard dosing Has drug interactions Separate from interacting meds by 2-3 hrs —
"Dulcolax" brand name ALSO used for bisacodyl (different
Docusate Multiple RCTs show NO benefit over Pregnancy
OTC drug/MOA) — confusion risk; docusate sodium suspension
calcium/sodium placebo Category B
also used as earwax softener (1mL irrigation)
GI — Constipation: Osmotic, Lubricant & Enemas
20g packet = 30mL suspension (NOT bioequivalent Check electrolytes q6-12mo if used ≥6mo Strep mutans can't digest it well — minimal cavity risk Pregnancy
Lactulose
forms) daily (unlike sorbitol) Category B
Strep mutans CAN digest it — increased cavity risk with Pregnancy
Sorbitol Standard dosing Causes flatulence via fermentation
chronic use Category C
First-line
MW 3,350 daltons; onset ~1 day; chronic
Polyethylene glycol FDA-approved only 7 days but used chronically in Case reports of pediatric irritability — likely confounded by pharmacologic
ethylene glycol exposure <1/15th of FDA
3350 (MiraLAX) practice incl. children/pregnancy underlying chronic constipation, not proven causal constipation
drinking-water limit
therapy
GoLytely Colonoscopy prep Contains electrolytes (unlike MiraLAX) Used specifically to fully clean out the bowel pre-colonoscopy —
Glycerol Enema or suppository Onset ~1 hour Advise patient to stay near a bathroom —
NOT in children or GERD pts — lipid pneumonitis risk if
Mineral oil Empty stomach; max 7 days Fallen out of favor Not in pregnancy
aspirated; decreases fat-soluble vitamin absorption
Bisacodyl / Senna Senna syrup: 8.8mg or 176mg strength, 10-15mL 1- Max 7 days — hypokalemia risk; oral "Dulcolax" is ALSO the brand name for bisacodyl — same
—
(stimulants) 2x/day (both strengths dosed the same) onset 6-12h, rectal ~1h name, different drug than docusate sodium's Dulcolax
Also reacts with stomach HCl to form MgCl2 (antacid effect)
Magnesium (saline
Max 7 days Avoid if GFR <30 (accumulation risk) — combined w/ aluminum hydroxide when used as antacid, —
laxative)
but NOT combined when used as a laxative
Enemas (sodium
Pink Lady = docusate + magnesium citrate + mineral oil + Na
phosphate/soap Soap suds: 15% abdominal pain vs 6% Only Pink Lady is
Onset 5-15 min phosphate compounded; Na phosphate carries dehydration
suds/saline/Pink (Pink Lady) vs 6% (Na phosphate) Rx
risk (high sodium draws water out)
Lady)
GI — Specialty Constipation Agents
↑ bowel
obstruction risk w/
Methylnaltrexone 8mg/12mg SC injection (more efficacious) or tablet; Does not cross BBB — no effect on analgesia, not a
Cancer pts <62kg: stay at 8mg, no titration impaired GI wall
(Relistor) start 8mg → 12mg once pain resolves controlled substance
integrity (GERD,
IBD)
Naldemedine Fetal abnormalities seen in animal studies unlike the other two Pregnancy
Standard peripheral mu-antagonist dosing Only agent in its class w/ Category D
(Symproic) agents Category D
FDA-approved ONLY for opioid-induced Stimulates/restarts peristalsis via cholinergic/non-adrenergic
Prucalopride 5-HT4 agonist —
constipation transmission
Plecanatide / FDA-approved for chronic constipation of Increase fluid absorption into stool via GC-C in intestinal
Guanylate cyclase-C agonists —
Linaclotide ANY etiology (incl. IBS-C) lumen
High-yield details, numbers, and distinguishing facts pulled from lecture notes — organized by drug class.
Pregnancy /
Medication Dose / Form Details Key Numbers & Stats High-Yield Distinguishing Fact
Monitoring
GI — H2 Blockers
Withdrawn 4/2020; reformulated version FDA- Degraded into NDMA (carcinogen) at New formulation: moisture-protected container, discard 90
Ranitidine —
approved 11/2025, Rx-only high temps — not contamination days after opening
Only other H2 blocker w/ dimethylamine
Nizatidine Standard H2 blocker dosing group; NDMA found in some lots but far Does not rapidly degrade into NDMA like ranitidine did —
less than ranitidine had
10mg & 20mg tabs OTC; 20mg chewable OTC; 40mg 14% of infants become agitated; 1% of
Famotidine Most commonly used OTC H2 blocker —
tab Rx adults get ED
Most drug interactions of the H2 blockers — most clinically
Cimetidine Standard H2 blocker dosing 4% of men develop gynecomastia —
significant class member for interactions
GI — Proton Pump Inhibitors
Omeprazole Converts to same active ingredient as AVOID with clopidogrel (Plavix) — drug interaction; use
Take on empty stomach, AM; can go BID —
(Prilosec) esomeprazole in acidic environment pantoprazole instead
Esomeprazole Same active ingredient as omeprazole Marketing implies superiority to Prilosec; pharmacologically
Take on empty stomach, AM —
(Nexium) once activated — NOT stronger equivalent
Generally preferred PPI for patients on
Pantoprazole Take on empty stomach, AM Go-to PPI when avoiding the omeprazole/Plavix interaction —
clopidogrel
Monitor
94% H+/K+ ATPase pump inhibition; 8-
Empty stomach; BID = before breakfast + before dinner Irreversible binding = no tachyphylaxis but severe rebound B12/iron/Ca/Mg
PPIs (class) week rebound acidity onset; 2-month
if PM symptoms hyperacidity; taper by halving dose q2-4wks to stop annually w/
course → up to 11-month rebound
chronic use
GI — Antacids & Protective Agents
1g = 400mg elemental calcium; separate
↑ risk hypercalcemia w/ HCTZ; avoid in recurrent Ca kidney
Calcium carbonate from
Take WITH food stones; >6mo use in males linked to arterial calcium —
(Tums/Maalox) fluoroquinolones/tetracycline/multivitamin
deposition
s/iron by 2-3 hrs
Often paired w/ magnesium antacids to offset each other's GI
Aluminum hydroxide Take AFTER meals Causes constipation —
effects
Reye syndrome risk in kids w/ viral illness (chickenpox/flu)
Bismuth subsalicylate Avoid in
Not >6 weeks daily use Salicylate-based — avoid pediatrics & pregnancy; forms black stool/tongue
(Pepto-Bismol) pregnancy
(harmless)
Best option for breakthrough sx while tapering off chronic Pregnancy
Sucralfate (Carafate) 2-4x/day, empty stomach Only 2% get constipation
PPI; not a standalone first-line Category B
Sole indication: prevent NSAID-induced ulcers in high-risk Pregnancy
Misoprostol Take WITH food ~10% get diarrhea/abdominal pain
pts; also an abortifacient — never in reproductive-age females Category X
Does NOT reduce/prevent gas production — just makes it
Simethicone (Gas-X) PRN Decreases gas bubble surface tension —
easier to pass
, Pregnancy /
Medication Dose / Form Details Key Numbers & Stats High-Yield Distinguishing Fact
Monitoring
GI — Constipation: Bulk-Forming & Stool Softeners
Husk (grainy) or hydrophilic mucilloid (fine powder) Requires adequate hydration — risk of bowel obstruction if Pregnancy
Psyllium OTC
forms dehydrated + constipated Category B
Polycarbophil Standard dosing Has drug interactions Separate from interacting meds by 2-3 hrs —
"Dulcolax" brand name ALSO used for bisacodyl (different
Docusate Multiple RCTs show NO benefit over Pregnancy
OTC drug/MOA) — confusion risk; docusate sodium suspension
calcium/sodium placebo Category B
also used as earwax softener (1mL irrigation)
GI — Constipation: Osmotic, Lubricant & Enemas
20g packet = 30mL suspension (NOT bioequivalent Check electrolytes q6-12mo if used ≥6mo Strep mutans can't digest it well — minimal cavity risk Pregnancy
Lactulose
forms) daily (unlike sorbitol) Category B
Strep mutans CAN digest it — increased cavity risk with Pregnancy
Sorbitol Standard dosing Causes flatulence via fermentation
chronic use Category C
First-line
MW 3,350 daltons; onset ~1 day; chronic
Polyethylene glycol FDA-approved only 7 days but used chronically in Case reports of pediatric irritability — likely confounded by pharmacologic
ethylene glycol exposure <1/15th of FDA
3350 (MiraLAX) practice incl. children/pregnancy underlying chronic constipation, not proven causal constipation
drinking-water limit
therapy
GoLytely Colonoscopy prep Contains electrolytes (unlike MiraLAX) Used specifically to fully clean out the bowel pre-colonoscopy —
Glycerol Enema or suppository Onset ~1 hour Advise patient to stay near a bathroom —
NOT in children or GERD pts — lipid pneumonitis risk if
Mineral oil Empty stomach; max 7 days Fallen out of favor Not in pregnancy
aspirated; decreases fat-soluble vitamin absorption
Bisacodyl / Senna Senna syrup: 8.8mg or 176mg strength, 10-15mL 1- Max 7 days — hypokalemia risk; oral "Dulcolax" is ALSO the brand name for bisacodyl — same
—
(stimulants) 2x/day (both strengths dosed the same) onset 6-12h, rectal ~1h name, different drug than docusate sodium's Dulcolax
Also reacts with stomach HCl to form MgCl2 (antacid effect)
Magnesium (saline
Max 7 days Avoid if GFR <30 (accumulation risk) — combined w/ aluminum hydroxide when used as antacid, —
laxative)
but NOT combined when used as a laxative
Enemas (sodium
Pink Lady = docusate + magnesium citrate + mineral oil + Na
phosphate/soap Soap suds: 15% abdominal pain vs 6% Only Pink Lady is
Onset 5-15 min phosphate compounded; Na phosphate carries dehydration
suds/saline/Pink (Pink Lady) vs 6% (Na phosphate) Rx
risk (high sodium draws water out)
Lady)
GI — Specialty Constipation Agents
↑ bowel
obstruction risk w/
Methylnaltrexone 8mg/12mg SC injection (more efficacious) or tablet; Does not cross BBB — no effect on analgesia, not a
Cancer pts <62kg: stay at 8mg, no titration impaired GI wall
(Relistor) start 8mg → 12mg once pain resolves controlled substance
integrity (GERD,
IBD)
Naldemedine Fetal abnormalities seen in animal studies unlike the other two Pregnancy
Standard peripheral mu-antagonist dosing Only agent in its class w/ Category D
(Symproic) agents Category D
FDA-approved ONLY for opioid-induced Stimulates/restarts peristalsis via cholinergic/non-adrenergic
Prucalopride 5-HT4 agonist —
constipation transmission
Plecanatide / FDA-approved for chronic constipation of Increase fluid absorption into stool via GC-C in intestinal
Guanylate cyclase-C agonists —
Linaclotide ANY etiology (incl. IBS-C) lumen
