Pocket Guide to GASTROINTESTINAL DRUGS Edited by M. Michael Wolfe | Robert C. Lowe Pocket Guide to Gastrointestinal Drugs Pocket Guide to Gastrointestinal Drugs Edited by 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 Robert C. Lowe, MD GI Fellowship Director Boston Medical Center; Associate Professor of Medicine Boston University School of Medicine Boston, MA, USA This edition fi rst published 2014 © 2014 by John Wiley & Sons, Ltd. 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The publisher and the author make no representations or warranties with respect to the accuracy or completeness of the contents of this work and specifi cally disclaim all warranties, including without limitation any implied warranties of fi tness for a particular purpose. In view of ongoing research, equipment modifi cations, changes in governmental regulations, and the constant fl ow of information relating to the use of medicines, equipment, and devices, the reader is urged to review and evaluate the information provided in the package insert or instructions for each medicine, equipment, or device for, among other things, any changes in the instructions or indication of usage and for added warnings and precautions. Readers should consult with a specialist where appropriate. The fact that an organization or Website is referred to in this work as a citation and/ or a potential source of further information does not mean that the author or the publisher endorses the information the organization or Website may provide or recommendations it may make. Further, readers should be aware that Internet Websites listed in this work may have changed or disappeared between when this work was written and when it is read. No warranty may be created or extended by any promotional statements for this work. Neither the publisher nor the author shall be liable for any damages arising herefrom. 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 Set in Palatino LT Std 9/12 pt by Aptara Inc., New Delhi, India 1 2013 Contents 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 v vi | Contents 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 specifi c 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 effi cacy, 84 Pharmacology: preparations and dosing, 87 Mechanism of action, 89 Bioavailability and metabolism, 89 Contents | vii 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 viii | Contents 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 Andrés Cárdenas 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 Contents | ix 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 x | Contents Protein, 238 Carbohydrate, 239 Lipids, 239 Enteral liquid feeding formulations, 239 Disease-specifi c formulas, 244 Selection of an appropriate