1.1 Antacids and Other Drugs for Dyspepsia 1.1.1 Aluminium

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1. Drugs acting on the Gastrointestinal System 1.1 Antacids and other drugs for dyspepsia 1.1.1 Aluminium- and magnesium- containing Aluminium hydroxide antacids Co-magaldrox (Mucogel®) Magnesium trisilicate 1.1.2 Antacid preparations containing simeticone Asilone® (for use in accordance with the Palliative Care Pain and Symptom Control Guidelines) 1.1.3 Other drugs for dyspepsia and gastro- Algicon® (second-line alginate) oesophageal disease Gaviscon Advance® liquid (first-line alginate) Gaviscon Infant® (Neonatal Unit only) 1.2 Antispasmodics and other drugs altering gut motility Alverine (Gastroenterology only) Dicycloverine Domperidone Hyoscine-n-butyl bromide Mebeverine Metoclopramide Peppermint oil 1.3 Ulcer-healing drugs 1.3.1 H2-receptor antagonists Cimetidine Ranitidine 1.3.3 Chelates and complexes Sucralfate 1.3.5 Proton pump inhibitors - Omeprazole capsules (first line PPI - Losec MUPS are non-formulary) see Salford PPI Strategy and Guidelines Lansoprazole orodispersible tablet (FasTab®) (for patients unable to swallow tablets) Rabeprazole (Gastroenterologists and Gastroenterology Surgeons only) 1.4 Acute diarrhoea 1.4.1 Adsorbents & bulk-forming Kaolin mixture 1.4.2 Antimotility drugs Codeine phosphate Loperamide 1.5 Chronic bowel disorders Colifoam® (hydrocortisone) Infliximab (in accordance with NICE guidance) - Follow restricted high cost drug procedure when prescribing infliximab Mesalazine Predenema® Predfoam® Predsol® Sulfasalazine Clipper® (Beclometasone dipropionate) (consultant gastroenterologist only) Budesonide Rectal Foam (consultant gastroenterologist only) Adalimumab (for Crohn’s disease) 1.6 Laxatives 1.6.1 Bulk forming laxatives Ispaghula husk (Fybogel®) Methylcellulose Sterculia (Normacol®) 1.6.2 Stimulant laxatives Bisacodyl Co-danthramer Co-danthrusate Docusate sodium Glycerol suppositories Senna Sodium picosulfate Neostigimine 1.6.3 Faecal softeners Arachis oil enema 1.6.4 Osmotic laxatives Lactulose (Gastroenterology only) Movicol® (do not use first line) Phosphate enema Micralax micro-enema® 1.6.5 Bowel cleansing solutions Fleet Phospho-soda® Klean-prep® Picolax® 1.7 Preparations for haemorrhoids 1.7.1 Soothing haemorrhoidal preps Anusol® 1.7.2 Compound preps with corticosteroids Anusol-HC® Xyloproct® 1.7.3 Rectal sclerosants Phenol 1.7.4 Management of anal fissures Dltiazem 2% cream (unlicensed - should not be used first line) Glyceryl trinitrate 0.4% (Rectogesic®) (for use in the treatment of anal fissure) 1.8 Stoma Care - contact Stoma Care Specialist for advice Dansac® soft paste 1.9 Drugs affecting intestinal secretions 1.9.2 Bile acid sequestrants Colestyramine 1.9.4 Pancreatin Creon® Pancrease® .

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Medicines That Affect Fluid Balance in the Body
the bulk of stools by getting them to retain liquid, which encourages the Medicines that affect fluid bowels to push them out. balance in the body Osmotic laxatives e.g. Lactulose, Macrogol - these soften stools by increasing the amount of water released into the bowels, making them easier to pass. Older people are at higher risk of dehydration due to body changes in the ageing process. The risk of dehydration can be increased further when Stimulant laxatives e.g. Senna, Bisacodyl - these stimulate the bowels elderly patients are prescribed medicines for chronic conditions due to old speeding up bowel movements and so less water is absorbed from the age. stool as it passes through the bowels. Some medicines can affect fluid balance in the body and this may result in more water being lost through the kidneys as urine. Stool softener laxatives e.g. Docusate - These can cause more water to The medicines that can increase risk of dehydration are be reabsorbed from the bowel, making the stools softer. listed below. ANTACIDS Antacids are also known to cause dehydration because of the moisture DIURETICS they require when being absorbed by your body. Drinking plenty of water Diuretics are sometimes called 'water tablets' because they can cause you can reduce the dry mouth, stomach cramps and dry skin that is sometimes to pass more urine than usual. They work on the kidneys by increasing the associated with antacids. amount of salt and water that comes out through the urine. Diuretics are often prescribed for heart failure patients and sometimes for patients with The major side effect of antacids containing magnesium is diarrhoea and high blood pressure.
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1770 Gastrointestinal Drugs respectively, and other airway, eye, and skin symptoms were rel- Homoeopathy. Senna leaf has been used in homoe- NOTE. Do not confuse with Dimeticone (p.2032). atively frequent.3 opathic medicines under the following names: Senna; Compounded preparations of simeticone may be represented by A 2-year history of pruritic scaly erythematous plaques on the the following names: 4 Senna folium. palmoplantar surfaces was reported by a patient who had taken • Co-simalcite x/y (BAN)—where x and y are the strengths in a sennoside laxative for 20 years. The lesions subsided over Administration in children. In the UK, the following oral milligrams of simeticone and hydrotalcite respectively. about 6 weeks on stopping the drug, and reappeared over the doses of sennosides are licensed for use for constipation in chil- course of 8 weeks on restarting sennoside. However, patch test- dren: Pharmacopoeias. In Eur. (see p.vii) and US. Ph. Eur. 6.2 (Simeticone). It is prepared by incorporation of 4 to ing and lymphocyte stimulation tests for sennoside were nega- • aged 2 to 6 years: 3.75 to 7.5 mg once daily in the morning tive. 7% silica into poly(dimethylsiloxane) with a degree of poly- • aged 6 to 12 years: 7.5 to 15 mg once daily at night or in the 1. Helin T, Mäkinen-Kiljunen S. Occupational asthma and rhinoc- merisation between 20 and 400. It contains 90.5 to 99.0% of onjunctivitis caused by senna. Allergy 1996; 51: 181–4. morning poly(dimethylsiloxane). It is a greyish-white, opalescent, viscous 2.
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