คู่มือการใช้ยาอย่างสมเหตุสมผล ระบบ GI

1
Thai National Formulary 2008

Volume 1 Gastro-intestinal system

(Disclaimer)

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Thai National Formulary 2008 Volume 1 Gastro-intestinal system

ISBN
: 978-974-244-276-7

:

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2548

1/2548
23 .. 2548

.. 2551

-2
( )
-3
(Thai National Formulary, TNF)

( )
-4
1
1.1 (dyspepsia)
(gastro-esophageal reflux disease)
1.1.1 (antacid) simeticone (simethicone)
1.1.2 (anti-flatulence)
1.2 (antispasmodic)
1.2.1 (antimuscarinic)
1.2.2 (other antispasmodics)
1.2.3 (motility stimulant)
1.3 (ulcer-healing drug)
1.3.1 2 (H2-receptor antagonist)
1.3.2 (selective antimuscarinic)
1.3.3 (chelate and complex)
1.3.4 (prostaglandin analogue)
1.3.5 (proton pump inhibitor - PPI)
1.3.6 (other ulcer-healing drugs)
1.3.7
(drug used in variceal bleeding)
-1
-3
-4
-6
-7
-8
-14
-17
-1
-29
-39
1
1
3
8
9
10
13
14
14
18
21
21
23
23
28
29
1.4 (Drug used in acute diarrhea)

1.4.1 (adsorbent) (bulk-forming agent)
1.4.2 (antimotility drug)
1.4.3
1.4.4
1.5
(Drug used in chronic bowel disorders)
1.5.1 aminosalicylate
1.5.2 corticosteroid
1.5.3 cytokine inhibitor
1.6 (laxatives)
1.6.1 (bulk-forming laxative)
1.6.2 (stimulant laxative)
1.6.3 (fecal softener)
1.6.4 (osmotic laxative)
1.6.5
(bowel preparation)
1.7
(local preparation for anal and rectal disorder)
1.7.1 (soothing hemorrhoidal
preparations)
1.7.2 (compound
hemorrhoidal preparations with corticosteroid)
1.7.3 (rectal sclerosant)
1.7.4 (management of anal fissure)
1.8 (stoma care)
1.9 (drug affecting intestinal
secretion)
1.9.1 (drug affecting biliary
composition and flow)
1.9.2 (bile acid sequestrants)
1.9.3
1.9.4 (pancreatin)
-5
32
35
35
36
39
41
43
46
47
49
51
51
54
55
57
61
61
62
63
63
64
65
65
68
68
69
71
-6

" "
Dr.Dinesh K.Mehta British National Formulary

Dr.Richard Laing Policy, Access and Rational Use

" "
..
.
-7

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(TNF)"

17

1. (gastro-intestinal
system)
2. (cardiovascular
system)
3. (respiratory system)
4. (central nervous
system)
5. (infection)
6. (endocrine system)
7. -
(obstetrics, gynecology and urinarytract system)
8. (malignant disease
and immunosuppression)
9. (nutrition and blood)
10.
(musculoskeletal and joint disease)
11. (eye)
12. (ear nose and oropharynx)
13. (skin)
14. (immuno
logical products and vaccine)
15. (anesthesia)
16. (antidote)
17.
(contrast media and radiopharmaceutical)
2

(introduction)
(monograph)

prescription note

(monograph)

.

rINN
(Recommended International Nonproprietary Name)
INN

1

(+)

. . . . .

.
.

-9

(Drug Utilization Evaluation,
DUE)

1)

2) 1
1. 1

(authorized system)

- 10
2. .

vaginal tablet, rectal suppository, sublingual
tablet, enteric coated tablet, effervescent tablet,
orodispersible tablet, microspheres suspension
for injection
Ibuprofen film coated
tablet ibuprofen

"hosp" sol (hosp)
solution
IR cap/tab (immediate release cap/tab)

IR
cap, tab (tablet)

(capsule) immediate release

compressed tablet, film coated
tablet, sugar coated tablet
SR tab, SR cap

controlled release, extended release, modified

release, slow release
EC tab, EC cap
(enteric coated)
dry syrup

syrup oral solution oral
suspension

(
dextrose) ( sorbitol
glycerin propylene glycol)

( saccharin artificial
sweetener )
( hydroxyethylcellulose
methylcellulose)

2550
price list

(hosp)

(
British National Formulary)
( Micromedex Drugdex Drug
Evaluation)

(standard treatment guidelines)

.
Warning, Caution
Precaution

(
" "
)
G6PD Pregnancy
Category 2 US FDA Pregnancy
Categories Australian Drug Evaluation
Committee's Categories (ADEC)
1 2
. US FDA Pregnancy Categories 1

. ADEC 2
US Pregnancy Category A

1 (
- 11
US Pregnancy Category B

(
)

1 (
)
US Pregnancy Category C

(teratogenic) (embrycidal)

US Pregnancy Category D

)
US Pregnancy Category X
- 12
. ADEC Pregnancy Categories

ADEC Pregnancy Category A

(malformation)

ADEC Pregnancy Category B1

(malformation)


(malformation)


(malformation)

ADEC Pregnancy Category C
(malformation)

ADEC Pregnancy Category D

(malformation)

ADEC Pregnancy Category X
.
Contraindication

"
"
.
Adverse Reaction Sideeffect

"
"
.
Dose, Dosage Dosing
(Adminis-
tration)

BNF for children Gold
Standard Clinical Pharmacology
"" "
"
- 13

1 4 (
6 ) 1
4 ( 6 ) 4 (
6 ) 10 ( 12 )
4 ( 6 ) 10 (
12 )
- 14
,
,
,
,
,
()
,
,
()
,
,
,
,
,
,
=
=
=
=
=
=
=
=
=
=
=
=
=
=
=
=
=
=
=
=
=
=
=
=
=
=
=
=
=
=
=
hyperacidity
acidosis
delayed gastric emptying
pyloric stenosis
urinary incontinence
rhabdomyolysis
ataxia
irritable bowel syndrome
fecal impaction
agitation
acute dystonic reaction
extemporaneous preparation
radiological procedures
thrombocytopenia
agranulocytosis
maintenance dose
paresthesia
bolus
hypernatremia
alkalosis
ileal resection
hepatic impairment
renal impairment
persistent diarrhea
gastrointestinal disturbance
urinary obstruction
angioedema
bowel habit
modified release
angina
colic
,
,
,
,
,
,
,
=
=
=
=
=
=
=
=
=
=
=
=
=
=
=
=
=
=
=
=
=
=
=
=
=
=
=
=
=
=
=
=
=
=
=
=
- 15
griping
urinary urgency
xerostomia
ulcer
peptic ulcer
erosion
anal fissure
pancytopenia
radiographic, X-ray
hypersensitivity reaction
leucopenia
motion sickness
gastric discomfort
iron preparations
adjunct
sedatives ()
aseptic meningitis
pericarditis
malaise
abdominal discomfort
fatigue
GERD
relapse
myasthenia gravis
peripheral neuropathy
airways disease
gastroenteritis
ileal disease
acute inflammatory bowel disease
hepatic encephalopathy
necrotizing enterocolitis
atony of colon
megacolon
toxic megacolon
ulcerative colitis
ileus
- 16
,
,
=
=
=
=
=
=
=
paralytic ileus
ileostomy
colostomy
visual disturbance
tinnitus
proctitis
arrhythmia
- 17

ACEI
= angiotensin-converting enzyme
inhibitor
ADEC
= Australian Drug Evaluation
Committee
amp
= ampoule
ARB
= angiotensin receptor blocker
BNF
= British National Formulary
cap
= capsule
CNS
= central nervous system
COPD
= chronic obstructive
pulmonary disease
CrCl
= creatinine clearance
D5W
= dextrose 5% in water
DU
= duodenal ulcer
DUE
= Drug Utilization Evaluation
E. coli
= Escherichia coli
EC
= enteric coated
FDA
= Food and Drug Administration
g
= gram
G6PD
= glucose-6-phosphate
dehydrogenase
GERD
= gastroesophageal reflux disease
GDP
= gross domestic products
GU
= gastric ulcer
H. pylori = Helicobacter pylori
hosp
= hospital formulary
(

)
IBS
= irritable bowel syndrome
IM
= intramuscular
INN
= International Nonproprietary Names
INR
= International Normalized Ratio
IR
= Immediate Release
IV
LDL
LFT
mEq
mg
mixt
ml
mmol
mOsm
NSAID
=
=
=
=
=
=
=
=
=
=
oint
PAS
pwdr
QALY
SC
SR
sol
supp
susp
syr
tab
TNF
TSH
URI
US
USP
.
.
.
2
=
=
=
=
=
=
=
=
=
=
=
=
=
=
=
=
=
=
=
=
intravenous
low density lipoprotein
liver function test
milliequivalent
milligram
mixture
milliliter
millimole
milliosmole
non-steroidal
anti-inflammatory drug
ointment
para-aminosalicylic acid
powder
quality adjusted life year
subcutaneous
slow release
solution
suppository
suspension
syrup
tablet
Thai National Formulary
thyroid stimulating hormone
upper respiratory infection
United States
United States Pharmacopeia

-1
-2
"

41-91"1, 2

(rational drug use process)

(evidence based medicine)
(pharmacovigilance)

(pharmacoeconomic)
(affordability)
"" (rational drug therapy)

(Thai National Formulary-TNF)

-3

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10 (patient compliance)
10 "
"
1 (INDICATION)

1
1.1
1.2
1.3
1.4
1.5
1.1

(exudate)

189

(holistic)

1.2

GAS (Group A Streptococcal) tonsillitis
penicillin
V () erythromycin syrup ()3 roxithromycin
()
co-amoxiclav () cefdinir ()
azithromycin () levofloxacin ()
184

185

3, 4 systematic review
186, 187

quinolone

()
1.3

140/90 .
140/90 .

5
erythropoietin (2) 10-12 g/dl erythropoietin
12 g/dl

12 g/dl6 GnRH analog leuprorelin (2) central precocious

puberty
7

rescuer ()
controller ()
1.4

-5
1.5

cardiovascular
mortality NCEP ATP III guideline9

10
bisphosphonate ()
11
-6

2
orphenadrine ('>)"'& ,) &

! ( %) B) 1 % C &
( ! )3 '
$()'!
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Beers Criteria '
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(
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(
) 3
15, 16, 17, 46, 190

"
"
B1-6-12
2.2

2

glucosamine (
) 18

Scottish Medicines Consortium

3
"All forms of
degenerative osteoarticular disease. Primary &
secondary osteoarthrosis e.g. cervical arthrosis,
coxofemoral arthrosis, gonarthrosis, dorsal arthrosis, lumbosacral arthrosis, scapulohumeral
arthrosis, periarthritis, lumbago, fractures,
osteoarticular dystrophies, chronic & subacute
arthritis"19

-7
osteoarthritis
glucosamine
BMJ clinical evidence glucosamine
unknown effectiveness (
chondroitin)20 glucosamine

carisoprodol, chlorzoxazone,

eperisone, methocarbamol, orphenadrine
tolperisone (
)
(painful muscular
conditions)21
non-articular
rheumatism22
1 23
24

()
25

26
nicergoline ()

Neurodegenerative Disease Drugs27
"Signs & symptoms
of mental deterioration e.g. cognitive, affective,
behavioural & somatic disturbances associated
w/cerebral deterioration (chronic cerebrovascular
insufficiency &/or senile & presenile dementia,
Parkinson's disease); impaired memory, decreased
-8
vigilance & impaired conc, mood depression,

apathy, interpersonal relationships, lack of self-care,
asthenia, anorexia, tinnitus, dizziness. As a
coadjuvant in the rehabilitative treatment of
hemiplegic patients with ictus sequelae"27

Micromedex therapeutic use28
cerebrovascular
accident, cerebrovascular disease dementia

US FDA (inconclusive)
(recommendation) (not
useful) (should be avoided)
asthenia, anorexia, tinnitus, dizziness

bencyclane
hydrogen fumarate ( cerebral activator)29
"Essential phospholipids" ( hepatic
protectors) 30 pentoxifylline ( haemorrheologicals)31 serratiopeptidase enzyme (
anti-inflammatory enzyme) 32
multivitamins & minerals supplement for vision

& the eye33
wound healing, fracture & trauma, drug
abuse, alcoholism, serious illness, burn & surgery34

"Practice should be
based on discoveries announced in the medical
journals."191

( 1)

evidence based
()
-9
- 10
2.3

randomized controlled
trial (RCT), meta-analysis systematic
review

co-amoxiclav ()
(simple wound
laceration)
(11.5% 21%)
(p > 0.10)40
meta-analysis RCT 11

(odd ratio 1.16 [95% CI 0.77-1.78])41
prophylaxis

serratiopeptidase enzyme (
) (
) "

/
" 42 RCT

RCT chronic airway disease
29 43 RCT

44

45 serratiopeptidase

RCT, meta-analysis
- 11
systematic review
2.4
surrogate outcome
clinical endpoint outcome
bromhexine (
) capsule 30
1 3
bronchiectasis
21.5% 16 4
( baseline 20 )46

(non-relevant clinical benefit)
prazosin () doxazosin ()

(clinical end point
outcome) ALLHAT study47
doxazosin

surrogate outcome
(
aluminium hydroxide + magnesium hydroxide)
H2 blocker
(-GU
-DU) NSAID
dyspepsia

- 12
48 H2 blocker

GU DU
NSAID 49
2.5

()

GINA guideline
188
2.6
NSAID
osteoarthritis
treatment guideline American
College of Rheumatology acetaminophen
(drug of choice)50, 51
52 NSAID (
COX-I COX-II inhibitor)
50, 51
NSAID osteoarthritis
3 (RISK)

3
3.1
3.2
3.3
3.4
3.5
3.6

3.7
3.8

3.9

3.1
nifedipine ()
immediate release

(surrogate outcome)
(clinical endpoint outcome)
(1.06-2.83 )
53 beta-blocker
(relative risk for all cause
mortality) 1.7 (p = 0.016)54
JNC 655 JNC 75
.. 199956
..2547 nifedipine
immediate release short acting calcium
channel blocker diltiazem57 (
ischemic heart disease)

acute low back pain

anticholinergic effect 12
anaphylactic shock tolperisone58
aplastic anemia orphenadrine59
chlorzoxazone 60
carisoprodol61
BMJ clinical
evidence trade off between benefit
and harm ()62

diazepam
Prodigy Guidance63, 64

3.2 atorvastatin
() 65
metformin () 66
()67 loperamide ()
12 68 beta-blocker
69 quinolone
(tendon pain)70 clarithromycin ()
ergot ()71
- 13
3.3
rofecoxib,
valdecoxib, gatifloxacin, tegaserod
cisapride, fenoverine nimesulide (
)
(pharmacovigilance)

72, 76 73
74, 75 QT prolongation77
78 79, 80, 81, 82
3.4 chlorpropamide
erythromycin () ampicillin ()

chlorpropamide
glipizide ()
erythromycin
roxithromycin ()
ampicillin amoxicillin
() 7
( chlorpropamide
partial central diabetes insipidus
desmopressin )7
3.5
cimetidine ()
ranitidine ()

- 14
cimetidine sildenafil83 (
) terfenadine83 (
) chloroquine84 () metformin84
() ranitidine
cimetidine
cisapride, macrolide, quinolone

SSRI
3.6

pioglitazone () 85
sulfonylurea glipizide () 86
loperamide () 87 proton pump
inhibitor omeprazole () 88
antispasmodic dicycloverine () 89
mesalazine () 90 acetaminophen ()
G6PD
91 morphine ()

92

3.7
warfarin ()
INR
93 gatifloxacin (
)
94

2549 7 94
cinnarizine flunarizine (
)

95, 96
3.8

nimesulide ()

NSAID
idiosyncrasy ()97
80

98

80
3.9

COX-II Inhibitor NSAID

99, 166

NSAID (
acetaminophen ) NSAID
NSAID

- 15
4 (COST)

4
4.1
4.2
4.3

4.4
4.1

NSAID

Aerius
(desloratadine) Clarityne (loratadine)179
Sibelium (flunarizine) Stugeron
(cinnarizine)179 Norgesic (orphenadrine +
paracetamol) Tylenol (paracetamol)179
4.2

- 16
() ()
() ()
(The American College of Chest Physician)192

acute ischemic stroke (
thrombolysis) ()
clopidogrel

clopidogrel
() clopidogrel ()
thiazolidinedione ()
2 ()
metformin sulfonylurea

thiazolidinedione "
sulfonylurea
metformin secondary failure
metformin sulfonylurea"100
British National Formulary

2
3
4.3

celecoxib (
) conventional NSAID
10

celecoxib

celecoxib conventional
NSAID101
9 102 (cost utility) 10
1 QALY103 (
$50,000-$100,000 1.6-3,2
1 QALY104
1-3 GDP 1-3
1 QALY10)

10 103
( conventional NSAID)
81 105
4.4

()
()
()
() 2
5
(OTHER CONSIDERATIONS)

5
5.1
5.2
5.3
5.4
(evidence-based treatment guidelines)
5.5
5.6
5.1

4
179 72
13
dimenhydrinate () betahistine ()
cinnarizine, flunarizine, ergotamine B1-6-12
( 4 )
1

19
Disento
()
- 17
diiodohydroxyquinoline, furazolidone, neomycin

sulfate, phthalylsulfathiazole kaolin

()
NSAID 1
1
(cocktail therapy)
protocol
5.2

PRSP (Penicillin Resistant Streptococcal
Pneumoniae)
106

MRSA (Methicillin Resistant Staphylococcus Aureus)107 VRE (Vancomycin Resistant
Enterococcus)108

cephalosporin, co-amoxiclav ()
clarithromycin () azithromycin ()

S.pyogenes
penicillin
V () roxithromycin () clarithromycin () azithromycin () ciprofloxacin ()
- 18
H.pylori139 Mycobacterium avium

complex109 P.aeruginosa109
levofloxacin ()
XDR-TB (extensive drug-resistant tuberculosis)7 first line
second line 110

5.3

(effective list)111

ISafE
(Information, Safety, administration restriction,
frequency, Efficacy) EMCI (Essential
Medicine Cost Index)112
16

/ /

aciclovir cream ()113 serratiopeptidase enzyme
()114 glucosamine (
)115 nifedipine immediate
release ()116 nimesulide ()117
cinnarizine/ flunarizine ()7
celecoxib117 atorvastatin11
bisphosphonate10

118

analgesics "acetaminophen (paracetamol)
first line drug osteoarthritis"
NSAID

ciprofloxacin "1.
sequential therapy 2.

" ciprofloxacin
quinolone
ofloxacin, ciprofloxacin
levofloxacin

()

piperacillin + tazobactam ()
imipenem+cilastatin () meropenem ()

119

5.4
evidence-based treatment guideline (
standard
treatment guideline)

2 ADA (American Diabetic Association)
European Association for the Study of
Diabetes metformin ()
120
ACR (American
College of Rheumatology) paracetamol
() 50, 51
JNC 7 thiazide diuretic
()
diuretic
5
5.5

(fee for service)

(capitation)
121, 122, 123, 124

- 19
37,004
2549125 46,281
2550 125 54,904
2551125

126

123
127
128

Vioxx
(rofecoxib), Bextra (valdecoxib), Zelmac
(tegaserod) Tequin (gatifloxacin)
5.6
steroid inhaler
()

20% 10

3 .. 2549
1.7 10
- 20
6 (DOSE)
1-5

6
6.1
(subtherapeutic dose)
6.2
(overdose)
6.3
6.4
6.5

paracetamol 500 2
paracetamol
subtherapeutic dose
1-5

6.2
(overdose) paracetamol ()
500 2 4

(overdose) 67
( 15
)
6 6
paracetamol 24 4
132, 133
325
4 133 6 8 133
roxithromycin () 150
2 2 clarithromycin modified release (MR) 500
() 1 2

134, 135
6.1 (subtherapeuticdose) enteric coated ()

60 129

75-162 /130
1
40 131
20
paracetamol
injection 300
6.3

metformin () 3
tramadol ()
136 enalapril
() 137
ethambutol
() 138 prednisolone ()
severe persistent
asthma139

1
ethambutol 140
- 21
7
(METHOD OF ADMINISTRATION)
1-6

7
7.1
7.2 systemic
7.3
7.4
7.5
7.6
6.4
aciclovir ()
herpes zoster
herpes simplex3 penicillin G ()
3
()
3 hydrochlorothiazide ()

3

prednisolone () 20

The National Asthma Education and
Prevention Program 40-60
141
1-6

6.5

enalapril ()
5

2.5 142

3
( -46)
7.1

3 paracetamol injection (
)
paracetamol
() 91 60-98
30 91

- 22

paracetamol
lidocaine 36
7.2 systemic

(
) 143

144, 145
146
systemic

systemic
7.3
. penicillin V () dicloxacillin ()
roxithromycin () tetracycline () norfloxacin
()
147, 148, 134, 149, 150 co-amoxiclav () doxycycline
()
151, 152 amoxicillin () clarithromycin
() azithromycin () ofloxacin () ciprofloxacin
() levofloxacin ()
153, 71, 154, 155, 70, 156

clarithromycin MR135
()
.
157 simvastatin ()
158, 159, 160 3 prednisolone ()
161 tacrolimus ()
162 .
tetracycline () ciprofloxacin
() 149, 70 bisphosphonate
()
30 163 diazepam ()
grapefruit164 theophylline ()
165 NSAID166
167
.

1 (240 )25
1
163
135 129
7.4
ceftriaxone () aminoglycoside
i.v. bolus
30 168, 169

ceftriaxone168
I.V.
48
ceftriaxone 168
7.5

170
ephedrine () 3 171

1-2 172
1-2
173
7.6

- 23
8
(FREQUENCY OF DOSE)
1-7

8
8.1
8.2
8.3

1-7

8.1

dose

amoxicillin ()
4 2-3 153
enalapril () congestive heart
failure 2 142 propranolol ()
2-3 174
8.2

2-3 propranolol ()
1 atenolol ()
- 24
metoprolol ()
aciclovir
() 5
valaciclovir
( ) famciclovir
()
8.3

aminoglycoside, ciprofloxacin () vancomycin

() cephalosporins ceftazidime ()

9
(DURATION OF TREATMENT)
1-8

9
9.1
9.2
9.3
9.4

1-8

9.1

prophylaxis 24
175 NSAID

cinnarizine ()
flunarizine ()
95, 96
10
9.2

penicillins 10
Streptococcus Gr. A rheumatic
heart disease176 GU
DU 4
177
9.3

6 178

9.4

RM (repeat medication)

gliclazide ()
868 179
dementia galantamine
donepezil ( )

180

B1-6-12, cinnarizine, flunarizine,
nifedipine diltiazem immediate release
NSAID

- 25
10
(PATIENT COMPLIANCE)
1-5

6-9

10
10.1
10.2
10.3
10.4
1-5
6-9

10.1

- 26
bisphosphonate ()
( 30
1
30 )
163 (
) /
esophagitis, esophageal erosion esophageal
ulcer163 ()
()
thiazide ()
omeprazole () simvastatin ()

indapamide, esomeprazole atorvastatin

enalapril ()

quinolone
183
10.2

amoxicillin ()
ampicillin ()
( )
( 2-3
4 )
153, 181

internet CD-ROM
10.3

1

1 5
182
10.4
- 27
- 28
10

undergraduate post-graduate

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Asthma/Guidelines/asthma%20qrg%202008%
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149. Tetracycline Drug information. Lexi-Comp, Inc.
150. Norfloxacin Drug information. Lexi-Comp, Inc.
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prescribing_information/topical_ear_
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Guidelines (8th Edition).Chest. 2008 Jun;133
(6 Suppl):630S-669S.
- 39
"Medicines should
be prescribed only when they are necessary"

( )

( )
(
)

()
()
- 40
paracetamol
paracetamol
paracetamol

""
paracetamol
paracetamol
3-4
( ARB
thiazolidinediones metformin)

(complimentary medicine)

(
)

(generic non-proprietary
name)
BNF (British National
Formulary) generic
name

bioavailability
50
(product liability)

BNF, Micromedex, Clinical Pharmacology

- 41

(PCM paracetamol
GG glyceryl guaiacolate 3B
B1-6-12)

1.
3 mg 3.0 mg 0.3 g
2. 1
2 g 2000 mg
3. 1
500 mg 0.5 g
4. 1
300 microgram 0.3 mg
5.

0.5 ml .5 ml
6.
0.5-1 g
7.
microgram
nanogram unit u
8.
ml mL cc
- 42
9. p.r.n. ()
1 tab
p.o. q 4 h p.r.n. for fever 1 tab p.r.n.
10. ()
1 2 syringe
1 ml 3.5 ml
11.

rINN Recommended International Non-proprietary
Name ( BNF)
BAN (British Approved Name) United
State Adopted Name (USAN)
rINN
acyclovir
amoxycillin
amphetamine
beclomethasone
benzhexol
cephalexin
chlorpheniramine
cholecalciferol
cholestyramine
colistin sulphemethate
sodium
cyclosporine
dicyclomine
guaiphenesin
indomethacin
methicillin
procaine penicillin
thiabendazole
thyroxine sodium
rINN
aciclovir
amoxicillin
amfetamine
beclometasone
trihexyphenidyl
cefalexin
chlorphenamine
colecalciferol
colestyramine
colistimethate sodium
ciclosporin
dicycloverine
guaifenesin
indometacin
meticillin
procaine benzylpenicillin
tiabendazole
levothyroxine sodium
12.
3 12
90 84
100
7
7 14 28
13.
14.
p.o. = per os ()
a.c. = ante cibum ()
p.c. = post cibum ()
q.d. = quaque die o.d. = omni die (
)
b.d. = bis die b.i.d. = bis in die ( 2
)
t.d.s. = ter die sumendum t.i.d. = ter in
die ( 3 )
q.d.s. = quater die sumendum q.i.d. = quater
in die ( 4 )
o.m. = omni name ( )
o.n. = omni nocte h.s. = hora somni
( )
p.r.n. = pro re nata ()
q. 4 h. = quaque 4 hora ( 4 )
stat = immediately ()

o.d. oculus dexter
()
15. tablet, capsule,
rectal suppo, vaginal suppo

hepatotoxicity
nimesulide chlorzoxazone anaphylaxis
tolperisone aplastic anemia orphenadrine
drug dependence carisoprodol rhabdomyolysis fenoverine parkinsonism
cinnarizine/flunarizine
- 43

( G6PD deficiency)

. . . .

nimesulide, fenoverine,
paracetamol injection, cinnarizine/flunarizine,
immediate released nifedipine muscle relaxant

- 44

!
" #
rofecoxib,
valdecoxib, lumiracoxib, tegaserod
gatifloxacin % & ' ()
%#*+

%- etoricoxib moxifloxacin
.
/& !0 1 # +
%.
# /&0!
%.
'! /&0! 1%
!-3 %!+
%.(% 4 /&0!

%!

%
!
5 !
6

7

#&
!
"
!
#*+!
%6#& %&

beta-blocker
8

%#1%
( 3!
colestyramine /&
triglyceride !
400 mg/dl
/&
!%%* !(!

%(
86
/&0! (
'!) 6
%/#

#*+

+ /&0! /&(

!!
7(

/&0! 3>?

%& @?%
/&0! %
!

%#1%
! A*
6
%7/
/
(
%B

%% !
> ++>%

%
8 6 /& 0 ! !
/#
%
% anaphylaxis, StevenJohnson Syndrome ! 7
QT prolongation
% ( !

67> 4&
@?%1 ! B

!

%

!
%C
!
#

!%%* ! ! !

%(
8!
%

%%
%(
8%* D
8
! 1%
%%@EE
#/&0!
+
6(/&0! %( 4
!

%
8!

1 %
-
88

/#
! !
5

/
#
%(/(
1 %%6/
F)G#

systemic /! !
5
!

%

%

%?

8
%%
.>
%
%
>
A*8(&
% (
%6/

"#$%&
%(/
(>%!%!
%
(%

!
) > %%

%!@E

8 H?
#
!#*+ % !C
!A*

6/
7
6/

%

1 .>

7 cytotoxic agent
methotrexate
5 8 /

gold, NSAID, pancreatin, penicillamine "
proguanil (!
7 ACE inhibitor (1 .>

captopril)
8

%
( (stomatitis)
1% erythema multiforme (%!+ 7

%
Steven-Johnson) 6/#

%!+ "
&
sulfonamide "!%'(
)* %!+ A*
8 /
%7%
%! / DC.>
/ !
(!/
%! toxic epidermal necrolysis
( 7

% Lyell) 3
#*+

7 !

!

%6H?
#
!
(lichenoid eruptions)

#*+
% NSAID, methyldopa, chloroquine
+ thiazide gold A*

H?
#
!

+%

A* 6/#

"
&
-./ /!
%!+
#&(#.
*0

%
(+8
@E

%
!

chlorhexidine # !
%#@E '!
+1%&#!
8 @E 6(8
co-amoxiclav
8
%(# @E

>

% (

!%#@E (7

tetracycline A*/#
+ #*+ 3

%

+ %%"4 (
7 %%"4+ 4 )

%
3 % *
7 12 P *

+ + %%"4

%
7% 3
7
8 !
12 P
7+7 8
%
(

!%#@EA*
6(*(

% fluoride
8 "
! dental
fluorosis A* 8675 @E
(!

6% 7R
"
! hypoplasia #
@E
%@&%4(%
8 @E
6(#
!6 5
3 %@&%4

7
% #

8**
@&%43
%

!
&( (periodontium)

%#
! # 6 /#

phenytoin
%+

ciclosporin %
nifedipine (%!+ calcium channel blocker 5)

(
7

%
(

%

!%(

+ %

) 8

A*
#*+ % #*+

%
33 5 5
(
%%@E)
/5
/#
#
+8
> (7
"
!+8
(xerostomia) A* (/( (7#"
>

8@E/7

%+

(1 .>
+
)

8
"
!+8
6'7/# & (
1 %4 ) ")/8& (%!*
7 tricyclic
serotonin re-uptake inhibitor) /
( baclofen tizanidine) %!+ clonidine

%0##

8(&"
!+8

( clozapine, neostigmine)

>
%+8
6E

/&0! E
!
%
- 45
/&0!
%

%3%!C+8
A*

6/

% / ( clonidine,
methyldopa) vinca alkaloid

%!#+8

iodide
$&( phenothiazine " sulfonamide
&&&#

8
%%%(%

%&(* #
(metallic taste) !
#

+ amiodarone, captopril (" ACEI
) carbimazole, gold, griseofulvin, lithium,
metronidazole, penicillamine, propafenone,
terbinafine " zopiclone
- 46

( 30 )

lorazepam
12
42

(
)

( )

(
)

( paradoxical CNS stimulation
)

off label

(make children size medicine)

( kernicterus Reye's syndrome)

( 30 ) ( 1 )
( 1-6 ) ( 6-12 )

8 /
320 40
320

"
" (ideal body weight)

nomogram
2
2

(.)
(.) (..)
3.5
50
0.23
1
4.2
55
0.26
2
4.5
57
0.27
3
5.6
59
0.32
4
6.5
62
0.34
6
7.7
67
0.40
1
10
76
0.47
3
15
94
0.62
5
18
108
0.73
7
23
120
0.88
10
30
132
1.05
12
39
148
1.25
14
50
163
1.50
68
173
1.80
()
56
163
1.60
()
- 47

1-2 3-4 ()
- 48

(terminally ill patient)

(palliative care)

-
(

)

/

(analgesic)
opioid
paracetamol ( 4.7.1) NSAID (
10.1.1)
opioid
NSAID
NSAID (
)
bisphosphonate ( 6.6.2)
strontium
opioid

opioid ( 4.7.2) codeine
tramadol

morphine
hydromorphine, methadone,
oxycodone fentanyl (
4.7.2)

opioid
(equianalgesic dose)
50

30
60
10

200 codeine
( )

5-10

()
() 4

paracetamol paracetamol + codeine
5-10

10-20

50

NSAID
5-20

100 500

(breakthrough pain)
(rescue dose)
30
24
1-2
12
( 4
)

( paracetamol)
10-20 12
opioid
paracetamol + codeine 20-30
12

breakthrough pain

1/6 24
- 49
24

6 4
diamorphine
1 3

opioid

fentanyl TTS (transdermal
therapeutic system) .

( fentanyl TTS
4.7.2)
breakthrough pain

loperamide () 2-4 4
( 1.4) hyoscine hydrobromide ()
( 1.2)

( 1.1.1) ()
domperidone () 10 3

( 10.2.2) diazepam
() 5-10 ./ baclofen () 5-10
3
- 50

( 4.7.3)
tricyclic antidepressant ()

carbamazepine (, ) gabapentin ()
dexamethasone
() 8
nerve block

transcutaneous electrical nerve stimulation (TENS)

(off label nonlicensed)

dexamethasone () 16
4-5 4-6
dexamethasone ()
18.00 .
moist
inhalation
5 4

5 4 diazepam () 5-10
dexamethasone () 4-8

haloperidol () 1-3 8
chlorpromazine () 25-50
8

simeticone ()
( 1.1) metoclopramide ()
10 6-8
baclofen
() 5 2 chlorpromazine ()
10-25 6-8
prednisolone ()
15-30 dexamethasone () 2-4

opioid
(laxative)

lactulose () senna
() ( 1.6)
fungating growth
metronidazole

adrenaline ( 1
)

(
12.3.5)
nystatin () miconazole () (
12.3.2) fluconazole ()
( 5.2)
opioid ( hyoscine)

emollient ( 13.2.1)
colestyramine () ( 1.9.2)

(uremia)
phenytoin ()
carbamazepine () ( 4.8.1)
diazepam
phenobarbital () 50-200
2

dexamethasone () 8

( 4.6)
opioid

haloperidol ()
metoclopramide ()
- 51
4-5
opioid
metoclopramide ()
(prokinetic)
10 3

(functional bowel obstruction)

metoclopramide ()

haloperidol () 1.5
( 2 )
24

dexamethasone () 8-16

6-25

8.1

(discomfort)

benzodiazepine
temazepam ( 4.1.1)
9.5.1.2
- 52

(
-39)

(lightheadedness)
"" (prophylaxis)

(
atrial fibrillation)
statin
()

(postural
hypotension) (postprandial
hypotension)
cinnarizine flunarizine (
)
(sensitivity)

opioid benzodiazepine
- 53

NSAID

benzodiazepine

(narrow therapeutic range) digitalis

(simple
gravitational edema)

(2-3
)

(confusion)
(
)
(
)

(hangover)

(slurred speech)

( 4.1.1)

NSAID

(
)

stroke
NSAID

NSAID
()

rheumatoid arthritis
NSAID
paracetamol
- 54
NSAID ibuprofen
1.2
paracetamol
( 1 4 )
NSAID
NSAID
opioid paracetamol
NSAID

omeprazole (
1.3)

NSAID
NSAID
COX-II inhibitor celecoxib

digoxin ()
digoxin () 125
(62.5 )

250

( co-trimoxazole (), mianserin (),
orphenadrine)
warfarin ()
NSAID

( 1
-4)

RM (repeat medications)

p.r.n. ( )

(glibenclamide (), chlorpropamide) benzodiazepine ( nitrazepam,
flurazepam, diazepam (), alprazolam)
NSAID ( naproxen (),
piroxicam ())

telithromycin bronchitis, pharyngitis,
sinusitis tonsillitis
2550

Beers Criteria
Beers Criteria

Archives of Internal Medicine ..
- 55
1991 .. 2003

Revised Beers Criteria 2003
analgesic, tricyclic antidepressant, long
acting benzodiazepine, long acting oral hypoglycemic
agent, anti-cholinergic agent, sedative antihistamine,
long acting NSAID muscle relaxant
- 56

Inappropriate Prescribing in the Elderly Tool
(IPET) STOPP (Screening Tool of Older
Persons' potentially inappropriate Prescriptions)

STOPP

thiazide
beta-blocker
beta-blocker
calcium channel blocker
150
tricyclic antidepressant
( )
benzodiazepine
(
)
antihistamine
(diphenoxylate, loperamide,
codeine) (
)
proton pump inhibitor
8
theophylline
NSAID
NSAID
NSAID
NSAID
NSAID warfarin
NSAID

1.1
1.1.1
1.1.2
(dyspepsia) (gastro-esophageal reflux

disease)
(antacid) simeticone (simethicone)
(anti-flatulence)
.. 2551
Antacids and other drugs for dyspepsia
1. Aluminium hydroxide
chewable tab, tab, susp, susp (hosp)
2. Aluminium hydroxide +
Magnesium hydroxide
chewable tab, tab, susp, susp (hosp)
3. Simeticone (Simethicone)
chewable tab, susp
4. Aluminium hydroxide +
Magnesium hydroxide +
Simeticone 25-50 mg
chewable tab, tab
5. Compound Cardamom Mixture

mixt, mixt (hosp)
(Mist Carminative)
sodium bicarbonate
(dyspepsia)

( 1.3)

(functional dyspepsia)
Rome III (2006)

1.
(postprandial distress syndrome)
2. (postprandial fullness) 3.
(epigastric
pain syndrome)
Helicobacter pylori
H. pylori

( 1.3)
45-55

1.1 (dyspepsia) (gastro- esophageal reflux disease)
""

(gastro-esophageal reflux
disease; GERD)
(
)

antacid ()
Histamine H2-receptor antagonist () (
1.3.1)

proton pump
inhibitor () ( 1.3.5)

(

Barrett's esophagus)
proton pump inhibitor () ( 1.3.5)

proton pump inhibitor 4-6

Histamine
H2-receptor antagonist ()
proton
pump inhibitor
prokinetic drug metoclopramide

() ( 4.6)

12-18

Histamine H2-receptor
antagonist ()
omeprazole () ( 1.3.5)
omeprazole
2
1.1.1 (antacid) simeticone

(simethicone)
aluminium hydroxide ()
aluminium hydroxide + magnesium
hydroxide ()
simeticone (simethicone) ()
aluminium hydroxide + magnesium
hydroxide + simeticone ( )
bismuth subsalicylate

(ulcer dyspepsia)

(non-erosive gastro-esophageal reflux) (
1.1)
(functional non-ulcer
dyspepsia)
()

4
10
3-4

( 1.3)
acid neutralizing capacity

NSAID

NSAID

NSAID

aluminium magnesium
()

aluminium hydroxide ()

(> 7 mg%)

(osteomalacia)
magnesium hydroxide
magnesium hydroxide (milk of magnesia)

()
aluminium hydroxide
sodium bicarbonate

() ( 7.4.3)
() (acidosis) ( 9.2.1.3)
() ( 9.2.2)
sodium bicarbonate
bismuth (bismuthcontaining antacid) ( chelate)

bismuth subsalicylate (
H.pylori 1.3)
bismuth
(neurotoxic) (encephalopathy)

calcium (calciumcontaining antacid)
gastrin

(alkalosis) (milk-alkali
syndrome)
simeticone (simethicone) () (activated
dimeticone)

(flatulence)

lavage solution

gastroscopy colonoscopy
double contrast upper
gastrointestinal tract radiography

2
aluminium hydroxide magnesium trisilicate
( magnesium carbonate)

aluminium hydroxide magenesium
hydroxide atropine
hyoscine
atropine

sodium carbonate, oxethazaine, cuttle fish bone,
kaolin

( itraconazole, ketoconazole, ampicillin ester)

2

sulfasalazine,
mesalazine, bisacodyl, aspirin, diclofenac, PAS
ALUMINIUM HYDROXIDE
Tab Al(OH)3 500 mg 0.15
Susp Al(OH)3318 mg/5 ml (240 ml)

17.32
Chewable tab, Susp (Hosp)

(hyperphosphatemia)
renal osteodystrophy

(
)

(dyspepsia)

NSAID (
1.1.1 )
(
1.3)
1.1.1

(dialysis) (dialysis osteomalacia) (dialysis encephalopathy)
(dialysis dementia)

(US Pregnancy Category , ADEC Category A)

()

bacampicillin,
digoxin, gabapentin, isoniazid, itraconazole,
ketoconazole, methenamine, phenytoin, quinidine,
quinolone, rosuvastatin, sotalol, tacrolimus, tetracycline, thyroid hormone

2
aluminium hydroxide

()

( 9.8.2)

(fecalith)

(
)
(osteomalacia)
(osteoporosis)
(bone resorption)
2
()

300-600 3
50-150 /
4-6

600-1200
ALUMINIUM HYDROXIDE + MAGNESIUM

HYDROXIDE
Chewable tab, Tab dried aluminium

hydroxide gel 300 mg + magnesium hydroxide
85 mg 0.24
Susp aluminium hydroxide 271 mg
+ magnesium hydroxide 90 mg/5 ml (240 ml)
19.41
Susp (hosp)

NSAID (
1.1.1 )
(
)
(
1.3)
1.1.1
ALUMINIUM HYDROXIDE
MAGNESIUM HYDROXIDE ( 1.6.4)
ALUMINIUM HYDROXIDE
MAGNESIUM HYDROXIDE (
1.6.4)

(US
Pregnancy Category B, ADEC Category )

()

ALUMINIUM HYDROXIDE
ALUMINIUM HYDROXIDE

ALUMINIUM HYDROXIDE
2
()

()

acid neutralizing capacity
(ANC) ( ANC ) 80-140
( 30-60
)
3-6 1 3
(
7 . 12 . 18 . 23 .
8 . 10 . 13 . 15 . 19 . 21 .
23 . 7 )
10-20 20-60
( 4 )
80
6 5-15 3-6
4
()

acid neutralising
capacity (ANC) 80-140
( 6-10
) 3-6
1 3
1-4
16

acid neutralizing capacity (ANC)

USP Al(OH)3 ANC
0.0385 mEq/mg Mg(OH)2 ANC
0.0343 mEq/mg dry aluminum hydroxide
gel 1 Al(OH)3 0.765
ANC
11.75 mEq 13.52 mEq 5
SIMETICONE (SIMETHICONE)
Chewable tab 80 mg
0.35
Susp drop 40 mg/0.6 ml (15 ml)
15
(flatulence)

(infantile colic)
1.1.1

(US Pregnancy
Category C, ADEC Category )

simeticone
aspartame ( phenylalanine)

(phenylketonuria)
40-120
4
500
2-12 40 4
240
2 20
4
240
ALUMINIUM HYDROXIDE + MAGNESIUM
HYDROXIDE + SIMETICONE 25-50 mg
Chewable tab dried aluminium

hydroxide gel 300 mg + magnesium hydroxide
100 mg + simeticone 50 mg 0.32
Tab dried aluminium hydroxide gel 300 mg +

magnesium hydroxide 100 mg + simeticone 25
mg 0.22
suspension

15 Al(OH)3 918
Mg(OH)2 300 simeticone
60 simeticone
Al(OH)3 Mg(OH)2
(dyspepsia)
NSAID
( 1.1.1 )

simeticone
ALUMINIUM HYDROXIDE +
MAGNESIUM HYDROXIDE SIMETICONE
simeticone

Al(OH)3
250 Mg(OH)2 250 simeticone
25
12 2-4
4
12
Compound Cardamom Mixture (Mist
Carminative) sodium
bicarbonate ()

(anti-flatulence)
(indigestion)
1.1.1 mist carminative
150
2 14

( aluminium magnesium ) simeticone
activated charcoal,
calcium carbonate, cuttle fish bone, digestive
enzyme, kaolin, sodium bicarbonate
(cardamom) (clove)
(rhubarb) (camphor) (dill)
(fennel) (peppermint)
(cinnamon)

(
)
( sodium bicarbonate
)
( benzocaine, cuttle fish bone
kaolin)
(
sodium bicarbonate )
1.2 (antispasmodic)
COMPOUND CARDAMOM MIXTURE (MIST

CARMINATIVE)
sodium bicarbonate
Mixt 180 ml 10 240 ml

15 450 ml 19.21
Mixt (hosp)
compound cardamom tincture
capsicum tincture ginger tincture camphor
ethyl alcohol
(flatulence)

(US Pregnancy Category
, ADEC Category )

menthol
menthol
sodium bicarbonate 2

( )

15-30 3-4
5 3-4
1.2
(antispasmodic)
1.2.1
1.2.2
1.2.3
(antimuscarinic)
(other antispasmodic)
(motility stimulant)
.. 2551
Antispasmodics and other drugs altering gut motility
1. Dicycloverine hydrochloride
(Dicyclomine hydrochloride)
tab
2. Domperidone
tab (as base/maleate),

susp (as base/maleate)
10
3. Hyoscine butylbromide
(Hyoscine-n-butylbromide)
tab, syr, sterile sol
4. Metoclopramide
tab, syr, sterile sol
5. Mebeverine hydrochloride
tab
dicycloverine (dicyclomine) () hyoscine

butylbromide ()
mebeverine ()
(IBS)
(dopamine-receptor antagonist)
metoclopramide () domperidone () (
4.6)
prokinetic drug
cisapride ()

QT (QT prolongation)
torsade

.. 2540
270 70
macrolide
quinolone
(
)

( 2.3.1)
( 3.1.2) ( 4.6)
( 4.9.2)
( 7.4.2)
(cycloplegia)
( 11.5) (premedication) ( 15.1.5)
organophosphate ( 16
)
atropine sulfate 2.3 () 11.5
() 15.1.5 () 16 ()
tertiary amine dicycloverine hydrochloride ()
dicycloverine hydrochloride ()
hyoscine butylbromide ()
clidinium
oxyphencyclimine
propantheline bromide
(dicyclomine hydrochloride), atropine, hyoscine

hydrobromide, hyoscyamine l-hyoscine
(scopolamine) quaternary ammonium compound hyoscine butylbromide ()
clidinium, oxyphencyclimine propantheline
bromide quaternary ammonium
compound
()
()
dicycloverine hydrochloride
atropine ( 1/8 )

6 hyoscine butylbromide

atropine belladonna alkaloids
irinotecan

( Beers criteria -55)

(
)
(ulcerative colitis)

( ipratropium)
COPD
(
)
11

muscle relaxant ( orphenadrine) tricyclic
antidepressant ( amitriptyline) antihistamine
( chlorpheniramine) phenothiazine (
chlorpromazine) antiarrhythmia ( quinidine)
atypical antipsychotic agent ( clozapine)

(
10.2.1)

(
)

(
)
( )

12
DICYCLOVERINE (DICYCLOMINE) HYDROCHLORIDE
Tab 10 mg 0.45

(US Pregnancy Category B, ADEC
Category B1)

6

dicyclomine
(fluctuation)

(asphyxia)
10-20 3-4
80

2-12 10 3-4
40
6-23 5-10 15
3-4
6
HYOSCINE BUTYLBROMIDE
Tab 10 mg 0.60
Syr 1 mg/ml (60 ml) 10
Sterile sol amp 20 mg (1ml) 4.50
:

(US Pregnancy Category C,
ADEC Category B2)

( 9.8.2)
1.2.2 (other antispasmodic)
20 4
6-12 10 3
(IBS)
10 3
20 4

20
30 (
) 100

1.2.2 (other antispasmodic)
mebeverine hydrochloride ()
alverine citrate
drotaverine
fenoverine
fenpiverinium
pitofenone
tiropramide
mebeverine () alverine, fenoverine peppermint oil
(IBS)

alverine citrate
IBS drotaverine
IBS
13
(rhabdomyolysis)
fenoverine fenpiverinium
pitofenone

tiropramide
(peppermint)
MEBEVERINE HYDROCHLORIDE
Tab 135 mg 3.50

(IBS)

(US Pregnancy Category
, ADEC Category )

( 9.8.2)
()

10 135
3 20
14
1.2.3
(motility stimulant)
metoclopramide () 4.6
domperidone () 4.6
cisapride
metoclopramide () domperidone () (
4.6)

(non-ulcer
dyspepsia) metoclopramide

metoclopramide

( 4.7.4.1)

(oculogyric crisis)
()
domperidone

24 (
4.6) domperidone
(
investigational drug)
1.3
(ulcer-healing drug)
1.3.1
1.3.2
1.3.3
1.3.4
1.3.5
1.3.6
1.3.7
2 (H2-receptor antagonist)
(selective antimuscarinic)
(chelate and complex)
(prostaglandin analogue)
(proton pump inhibitor - PPI)
(other ulcer-healing drug)
(drug used in variceal
bleeding)
.. 2551
Ulcer-healing drugs and drugs used in variceal bleeding
1. Omeprazole
EC cap (as base)
2. Ranitidine hydrochloride
film coated tab
3. Omeprazole sodium
sterile pwdr
4. Ranitidine hydrochloride
sterile sol
5. Pantoprazole sodium
sterile pwdr
6. Sucralfate
tab, susp
7. Somatostatin acetate
sterile pwdr
15

1. pancreatic fistula
2. variceal bleeding portal hypertensive
gastropathy therapeutic endoscopic intervention
8. Lauromacrogol 400 (Polidocanol)
sterile sol

1. variceal bleeding endoscopy sclerotherapy
2. varicose vein hemorrhoid
9. Ranitidine bismuth citrate
tab

second-line drug H. pylori

(gastro-enterostomy stoma)

NSAID
Helicobacter pylori

H. pylori NSAID
Helicobacter pylori
H. pylori

3 (triple therapy)
omeprazole () amoxicillin ()
metronidazole () clarithromycin ()
1 H. pylori
90
(PPI H2-receptor
antagonist)
metronidazole
clarithromycin amoxicillin
16

amoxicillin
clarithromycin
amoxicillin metronidazole
metronidazole
.
clarithromycin .

ranitidine bismuth citrate () PPI
second line drug
4 (quadruple
therapy) clarithromycin metronidazole
3 2
1

2 (dual therapy)

2
tinidazole tetracycline () H.pylori

Helicobacter pylori
13C urea breath test (13CUBT)
13C urea
H.pylori

4
2

Helicobacter pylori
12
omeprazole (20 ) 2
amoxicillin 500 3
metronidazole 400 3 (
140 7 )
Helicobacter pylori
12
omeprazole 20 2
metronidazole 400 2
clarithromycin 500 2 (
320 7 )
omeprazole 20 2
amoxicillin 500 2
clarithromycin 500 2 (
385 7 )
ranitidine bismuth citrate 400

2 amoxicillin 1 2
metronidazole 400 2
( 510 7 )

2 metronidazole 400
2 clarithromycin 500
2 ( 700 7 )

2 amoxicillin 1 2
clarithromycin 500 2
( 740 7 )
12
Helicobacter pylori
Omeprazole
2-12 1-2 / ( 40
)
Amoxicillin 50 //
2
2-6 250 2
6-12 500 2
Clarithromycin 15 //
2
2-6 125 2
6-9 187.5 2
9-12 250 2
Metronidazole 20 //
2
2-6 100 2
6-12 200 2
17
NSAID (NSAIDassociated ulcer)

NSAID

NSAID

NSAID PPI omeprazole
20 / ( 40 /
) H 2-receptor antagonist
ranitidine 600 /
( 300 / )
( antacid
NSAID)
NSAID H.pylori
H.pylori
NSAID
NSAID
NSAID
NSAID
H.pylori

NSAID PPI
H2-receptor antagonist
NSAID
NSAID
PPI PPI (
PPI
)
NSAID COX-II inhibitor
PPI
PPI ( COX-II
18
inhibitor PPI)

COX-II inhibitor
COX-II inhibitor

1.3.1 2 (H2-receptor
antagonist)
ranitidine () ()
cimetidine
famotidine
nizatidine

H 2
(
1.1) Zollinger-Ellison syndrome

PPI

H. pylori
( 1.3)


H 2-receptor antagonist
NSAID (NSAID associated
ulcer) ()
omeprazole ( 1.3)

(Mendelson's syndrome)
H2-receptor
antagonist


(
)

(AV block)
( )
(
) (

)
( erythema multiforme toxic
epidermal necrolysis)
cimetidine
cytochrome P450
chloroquine,
metformin, phenytoin, theophylline ( aminophylline) warfarin ranitidine () ()
cimetidine
cimetidine

itraconazole, ketoconazole, bacampicillin
RANITIDINE HYDROCHLORIDE
Film coated tab 150 mg 0.43
19
(confusion)

(US Pregnancy Category B, ADEC Category B1)

NSAID
ranitidine ( 9.8.2)

(necrotizing
enterocolitis)

(interstitial nephritis)
12 150
2 300
1 4 8
6 -12 2-4 /
2 ( 150 /)
1-5 1 / 3
( 9 // 3 )
1-2 / 3
()
ranitidine

20
(chronic episodic dyspepsia)
6
NSAID

8
300 2 4

omeprazole

H. pylori
Helicobacter pylori

NSAID
12 300
2
12 150
2 300
8
12
2-4
150 2
Zollinger-Ellison syndrome (
omeprazole 1.3.1 )
12 150
3
6

12 150

6

(
)
150 2
150
Sterile sol amp 50 mg (2 ml) 5

RANITIDINE HYDROCHLORIDE film coated tablet
RANITIDINE HYDROCHLORIDE film coated tablet

RANITIDINE HYDROCHLORIDE film
coated tablet
1.3.2 (selective antimuscarinic)

(
)
50 45-60
50 45-60
20 2
stress ulcer
50 (
20 )
2
0.125-0.25 /
/
150 2
50 6-8
50 20
2 6-8
1 -18 1 /
( 50 ) 6-8
normal saline 5% glucose
2.5 / 3
0.5-1 / 6-8
normal saline 5% glucose
2.5 /
3
21
25 / 2
6-8
1 -18 1 / (
50 ) 25 /
24
0.03-0.06 //
( 3 //)
1 -18 0.125-0.25 //
1.3.2 (selective
antimuscarinic)
pirenzepine selective antimuscarinic

pirenzepine
sucralfate ()
ranitidine bismuth citrate ()
ranitidine bismuth citrate

() ranitidine bismuth
citrate H.pylori
sucralfate ()
aluminium hydroxide sulfated
sucrose

22
(bezoar) sucralfate

SUCRALFATE
Tab 1 g 4.50
Susp 1 g/5 ml (60 ml) 100
NSAID
1.3.3

sucralfate 1
207
aluminum osteodystrophy, osteomalacia
encephalopathy
(Pregnancy Category B, ADEC Category B1)

digoxin, warfarin,
furosemide, ketoconazole, phenytoin, quinolone,
tetracycline theophylline
2
bezoar 1.3.3
1
(bezoar)
( 1.3.3 )

NSAID (benign)
1 4 1
4-8
2 2
8

40-80 /
6

RANITIDINE BISMUTH CITRATE (RANITIDINE
BISMUTREX)
Tab 400 mg 24
second line
drug H. pylori

creatinine
clearance 25 /
(US
Pregnancy Category C, ADEC Category B1)

1.3.4 (prostaglandin analogue)
tetracycline quinolone
2

ranitidine
bismuth trivalent cation
(
) (
) ( 9.8.2)


erythema multiforme
H.pylori
2
400 2
( Helicobacter
pylori 1.3 )

1.3.4 (prostaglandin
analogue)
misoprostol
misoprostol prostaglandin

NSAID misoprostol

23
NSAID

misoprostol
() 7.1.1
1.3.5 (proton pump

inhibitor - PPI)
omeprazole () ()
pantoprazole ()
esomeprazole
lansoprazole
rabeprazole
PPI omeprazole () (), pantoprazole
() esomeprazole, lansoprazole, rabeprazole

hydrogen-potassium adenosine
triphosphatase (proton pump)

Helicobacter pylori
( Helicobacter pylori
1.3 ) PPI

( erosion ulcer)
PPI ( 1.1)
24
PPI
NSAID (
NSAID 1.3 )
NSAID
PPI

omeprazole ZollingerEllison syndrome (

)
proton
pump inhibitor

( 1.1 )

omeprazole sodium bicarbonate (

immediate
release oral suspension
) (AUC)
4

omeprazole
(simplified omeprazole suspension SOS) pH
itraconazole,
ketoconazole, bacampicillin, cilostazol B12
proton pump inhibitor

(
)

( angioedema
)
(interstitial
nephritis) (

)
B12
( toxic
epidermal necrolysis, bullous eruption)
OMEPRAZOLE
EC cap (as base) 20 mg 1

omeprazole magnesium (MUPS)
tablet

20 0.7 /


(US pregnancy category C, ADEC Category B3)

omeprazole
2
omeprazole

atazanavir, indinavir nelfinavir
warfarin, cilostazol, ampicillin
ester, H2-blocker, itraconazole, ketoconazole
B12
( 3
) B12
(hypochlorhydria)
(achlorhydria)

(paresthesia)

PPI
20 8

1 40
8
25
20 4
4

20

NSAID
20 4
4

NSAID
NSAID NSAID
20

H. pylori
Helicobacter pylori
1.3
Zollinger-Ellison syndrome
60
20-120 ( 80
2 )

()
40 40
2-6

20 4
4-8 (
40
26
8 ) 20
20 2-4
(GERD)
(severe
ulcerating reflux esophagitis)
2
10-20 10
20
4-12
20 20
40
4-12

H. pylori
Helicobacter pylori
1.3
2

omeprazole 2

(erosion)
NSAID
Zollinger-Ellison syndrome

()
0.7 /
7-14 1.4
/
2.8 /
1 2 0.7 /
3 /
( 20 )
omeprazole (tablet)
( 30
) 1

enteric coated
granules

50

omeprazole
(simplified omeprazole suspension - SOS
extemporaneous preparation)

()
8.4% 10
30

2 /
14
24 30
5 20 90
7
OMEPRAZOLE SODIUM
Sterile pwdr vial 40 mg 269
OMEPRAZOLE
OMEPRAZOLE
OMEPRAZOLE

40 1
40
5

27
1 -11 0.5 /
( 20 )
2 / ( 40 )
12-18 40

normal saline 5
5

normal saline D5W

normal saline 5
normal saline
D5W 50 10-30

( 30 ) 12
normal saline 12
D5W 6
PANTOPRAZOLE SODIUM
Sterile pwdr vial 40 mg 315

omeprazole

pantoprazole
20 0.7 /

28
1.3.6
(other ulcer-healing drugs)
pantoprazole
40

(US pregnancy category B,
ADEC Category B3) !"
#$%&
!
% !'* *+%!-! !&$

+
+%.!& / 1 !
2! PPI !5 6*78
9

! ' : pantoprazole !59

18 = ! 2 8-6 - *+%
8->6 ?! pantoprazole !
!!8->& 5'
2 2%:*
+
+%
: atazanavir 9
nelfinavir !
: warfarin, ampicillin ester, H2-blockers,
itraconazole, ketoconazole B12 9
7
5
"29
' 2%1 G+! pantoprazole
! 7+ 2% 2 & !'
!
2 !!"
(!-':)

!-8
'+ ! ! %'$
' !
+# !

8-*+%9
PPI 9
G+!+!7+ IV push,
IM 2 SC

!-"9" !

!'
!
2!!"
6" 98
9
98
"6
5:!
9 9
. !
8->*+%6 J
*!
40

&&*!
9 7
6" Zollinger-Ellison syndrome
%!'! 80
2 160

% !.! 5 & 80

'! 6
'!*+%
80
9 2

9":2%& 6*78
9

! ! 2

G+!'
!
2!!" + 2 7+ (G+! pantoprazole
!7+2% (!-':))

1 !'
!
2 !!" 2%
(15 minute infusion)

! normal saline
100

!'
!
2!!":
15 *+

2 G+!'
!
2!!":1
(2 minute infusion)

! normal saline
10

G+!'
!
2!!":1 .!:

2 *+
1.3.6 ! (other
ulcer-healing drugs)
carbenoxolone
bismuth subsalicylate (BSS) +O*7QR8
9

"6 9
+O*7Q
! !
:!+% ?98
+*+%:
'& !:2 H.pylori 9 quadruple therapy (8-
: BSS + omeprazole + tetracycline + metronidazole
2!5: BSS + omeprazole + &
:+ 2
: ! *+% O*7Q H.pylori ! 9 amoxicillin,
clarithromycin 2 metronidazole) .!& !
second line therapy 6" 8->*+% ?! first
line therapy .!7+ triple therapy !8

5 ' : + ' BSS !
6 W
carbenoxolone 7' glycyrrhizinic acid
(6 ' liquorice) : ?98
9

6*+%
! 9X&&
:9

1.3.7

!
(drug used in variceal bleeding)
1.3.7
"#"$
(drug used in variceal
bleeding)
somatostatin acetate ()
octreotide acetate
lauromacrogol 400 (polidocanol) ()
somatostatin Y . *+%
% & 9

hypothalamus ( ' 8.3.4.3) somatostatin
acetate () :6" ? pancreatic fistula *+%+
6-6+6% !
%& / (high
output) .!
% serotonin, peptide 9

6 !
%
:!& #$%+8
*"%
!-!#$
'"9

29 &
"6 &+
: somatostatin acetate !
2!
&6
2!'!
! .!
%
Y . *+% +% ' '
!
2 !:
glucagon 6 8

2 !
+
*! 9

*"!
2!

!
2!!" portal 9
6
2!'!
!
&$
:
2!&6
2!'!
!
! octreotide acetate G+!#$%
9
56 ' somatostatin +O*7Q 2
somatostatin 9 + $% :+ vasopressin
'! 0.4 - G+!"'
!
2!!" !
!'
!
2!!"2%'! 0.4-1.0
- /*+ &*"
!
2! mesenteric ! *"
!
!
2!!" portal
!
9 vasopressin
&6 J!
2!&6
2!'!
9 ! 98+

2!#" 9

:
! '8-> somatostatin + 6*78
2 vasopressin

2! (RR 1.62 95% CI 1.37-1.92)
9
+ 8
' + X & & &$ 9" :
somatostatin acetate lauromacrogol 400
hydroxypolyethoxydodecane polidocanol ()
29
+/6 6 *+%*"

!
2!9'5 (sclerosing
agent) &$&+ .: ?

2 !&6
2 !'!
! !
G+!'.! /*+%6
2!'! .!:
'! 20-30

(9 50

) X&& :!'! & 30

'!&+ " +9:!'! & 2

! #$%'!*+%& / :+

9: 2%&:':2%
OCTREOTIDE ACETATE
Sterile pwdr 0.1 mg/ml (1 ml) G
+% 465
* 2,425 * 2 3,082 * 9
8
/`
& :+
9 : G
-9G+!7 ! :! long acting 2
microspheres suspension for injection
%&
!- ' '!
'
8->&'& !!:
&&"
'! 9+ /` '!
62% 8- > &'& !!:
8- > *+% + creatinine
clearance 2 * 30

/*+
8-8
9"
!'!
$%$%
8 ! :'!6-&! & .
'* 8- 8
*{9"

+
+% (US Pregnancy Category B, ADEC
Category C) '+ -
86- "
2 8-8
*{9"
+
+% !5
&! & .2%:!

8-6 - +' -
:&" !
+
+% 2
! : *+%&*"
2%||R
&: QT '$ : class IA
antiarrhythmics (: quinidine), class III
antiarrhythmic (: amiodarone), chloroquine,
30
1.3.7 (drug used in variceal bleeding)
chlorpromazine, clozapine, halofanthrine, haloperidol,

macrolide ( erythromycin, clarithromycin),
pimozide, quinolone ( norfloxacin, ofloxacin,
ciprofloxacin), tacrolimus, terfenadine, thioridazine
tricyclic antidepressant

1

2
octreotide acetate

3-4
B12
somatostatin octreotide

(
)

()

TSH

octreotide

1.
2. somatostatin acetate octreotide

1 100
esophageal varices
IV bolus
50 3
50
48
endoscopic esophageal band
ligation 120
(Sung 1995)
pancreatic fistula
100 8
7 8
uncontrolled study
23 (Segal 1993)
SOMATOSTATIN ACETATE
Sterile pwdr amp 250 mcg 727

amp 3 mg 1,720
1. pancreatic fistula
2. variceal bleeding
portal hypertensive
gastropathy therapeutic endoscopic
intervention
1.3.7 (drug used in variceal bleeding)
OCTREOTIDE ACETATE
1-2
rebound effect

barbiturate
pentetrazol
OCTREOTIDE ACETATE
OCTREOTIDE ACETATE

( )
3

1.
2 somatostatin acetate octreotide

3.
31
1 3,000
250
esophageal varices pancreatic fistula
high output
IV bolus
3.5 / (250
75 ) (bolus)
3
3.5 /
/ (250 / 3
12 75 )

48-72
endoscopic esophageal band
ligation 120
pancreatic fistula
2-20
1-3
fistula
rebound hypersecretion
hypovolemia
air/fluid level

octreotide
somatostatin acetate rebound
32
1.4
(Drug used in acute diarrhea)
1.4.1
1.4.2
1.4.3
1.4.4
(adsorbent) (bulk-forming agent)

(antimotility drug)
.. 2551
Drugs used in acute diarrhea
1 Oral rehydration salts (ORS)
oral pwdr, oral pwdr (hosp)

- Sodium chloride
2.6 g
- Trisodium citrate dihydrate 2.9 g
- Potassium chloride
1.5 g
- Glucose
13.5 g
molar concentration
- Glucose
75 mmol - Sodium
75 mmol
- Chloride
65 mmol - Potassium
20 mmol
- Citrate
10 mmol
Osmolarity = 245 /

2 Zinc sulfate
oral sol (hosp)
5
10-14

3 Loperamide hydrochloride
cap, tab

12
CDC (Center of Disease

Control) (ORS) zinc
( )

( loperamide)
( ) (
dioctahedral smectite, kaolin, pectin)
( colistin, furazolidone,
sulfonamide co-trimoxazole, neomycin)
bismuth subsalicylate, lactobacillus
Disento PF suspension (furazolidone, pectin, light kaolin) Disento tab
(diiodohydroxyquinoline, furazolidone, neomycin,
pthalylsulphathiazole, light kaolin) opiate
codeine phosphate
1-8
( 4 ) 1

campylobacter shigella
salmonella norfloxacin
ciprofloxacin

E.coli O157
hemolytic uremic syndrome

(acute
gastroenteritis)
24-48

( rotavirus)
33
( salmonella)
campylobacter shigella
invasive salmonellosis

( 4)
ciprofloxacin () travellers' diarrhea

pseudomonas
colistin

colistin ()
acinetobacter
34

..
2005
zinc sulfate ()
5
()
(antimotility drug)
( 1.4.2) loperamide () diphenoxylate

diphenoxylate
atropine
( co-phenotrope
Lomotil)
loperamide
diphenoxylate
colonization
()
toxic megacolon
(antispasmodic) ( 1.2)
1.4.1 (adsorbent) (bulk-forming agent)
colestyramine () ( 1.9.2 colestyramine)

aluminium hydroxide mixture () (
1.1.1)

(antisecretory agent) racecadotril
(acetorphan) enkephalinase
enkephalin

1.4.4
bismuth subsalicylate (BSS)
BSS OTC (over the counter)

OTC 12
salicylate

( 4.6)

1.4.4
probiotics
( )
lactobacillus

1.4.4
1.4.1 (adsorbent)
(bulk-forming agent)
activated charcoal
dioctahedral smectite
kaolin kaolin + pectin
35
kaolin pectin

activated charcoal
off label
(
16. Antidotes
)
ispaghula, methylcellulose sterculia (
1.6.1)
(ileostomy)
(colostomy)

1.4.2 (antimotility
drug)
loperamide hydrochloride ()
diphenoxylate

( "")
()
(enterotoxin)

(antibiotic associated colitis)

( 9.2.1.2)
1.5 stoma care

1.8
36
1.4.3
LOPERAMIDE HYDROCHLORIDE
Tab/Cap 2 mg 0.42

12

(
1.4.2 )

first-pass metabolism

(US Pregnancy Risk
Category C, ADEC Category B3)

metoclopramide, cisapride, domperidone
diphenoxylate

( )

(antibiotic
associated colitis)

12

(necrotizing enterocolitis)
()

( "" )
12 4
(2 ) 2
6-8
(3-4 ) 16
5

12
4-8
1-2
16
10
1.4.3
oral rehydration salts ()
zinc sulfate ()

()

1.4.3

(
) (ORS) ()
hypo-osmolar ( 250
/)
(osmotic
diarrhea)

3-4 (
12 )

() ORS
()
ORS

nasogastric tube

24
6
24-48

37
()
5

10-14

ORAL REHYDRATION SALTS (ORS)
Oral pwdr 1.35 4.5

() 3.00 20 ()
Oral pwdr (hosp)
sodium chloride 2.6 g potassium
chloride 1.5 g trisodium citrate dihydrate (sodium
citrate) 2.9 g glucose (anhydrous) 13.5 g
1
Na+ 75 mmol, K+ 20 mmol,
Cl- 65 mmol, citrate 10 mmol, glucose 75 mmol
osmolarity = 245 /

glucose trisodium citrate
( ) 27
sodium bicarbonate () 2.5

()
38
1.4.3
(
)
(
)

200-400

Plan A
Plan B
4
75 /

10
1 2

Plan C

20 //
5 //
ZINC SULFATE
Oral sol elemental zinc

10 / 5 25 / 5
1.4.4
5
10-14

ORS
6 10

ORS 2 (10 ) 1
10 -14
6 5 20
ORS 1 (5 )
1
1 10-14
1.4.4
antisecretory agent racecadotril
bismuth subsalicylate (BSS)
probiotics lactobacillus
bifidobacterium
furazolidone +
pthalylsulphathiazole (2 ), furazolidone +
pectin + kaolin (3 )
diiodohydroxyquinoline + furazolidone +
neomycin + pthalylsulphathiazole + kaolin
(5 )
39
racecadotril

loperamide systematic review .. 2007
(3 471 )


loperamide

(encephalopathy)

BSS
salicylic acid prostaglandin
salicylate

( 4.6)
probiotics

(colonization)

probiotics
Lactobacillus acidophilus Bifidobacterium
40
1.4.4
1 Lactobacillus
rhamnosus GG Saccharomyces boulardii

probiotics Lactobacillus casei
( reuteri)

probiotics
0.7

( furazolidone, sulfonamide, neomycin)

StevenJohnson syndrome
41
1.5
1.5.1
1.5.2
1.5.3
aminosalicylate
corticosteroid
cytokine inhibitor
.. 2551
Drugs used in chronic bowel disorders
1. Sulfasalazine
tab, EC tab

chronic inflammatory bowel disease
2. Mesalazine (Mesalamine)
EC tab, rectal supp

1. sulfasalazine
2. ulcerative colitis ( sigmoid rectum)

radiation proctitis

(irritable
bowel syndrome - IBS)

( 1.6)

loperamide () ( 1.4.2)
(antispasmodic
drug) mebeverine () ( 1.2)

opioid codeine
(malabsorption
syndrome)
celiac disease (gluten enteropathy)

(pancreatin) ( 1.9.4)
42
1.5

(inflammatory bowel
disease)
,%,C-

(ulcerative colitis) !
(Crohn's disease regional enteritis) 3
'*+ 1
" %,

B"
D*'*+?4 (chronic active)
1 ' 1
? , aminosalicylate sulfasalazine
() ! mesalazine () %,' corticosteroid
(%& 6.3) " prednisolone () =E
3

!"#$%&
(ulcerative colitis) '&'*+& ! "',!
(Crohn's disease) 34,+ &F*=
'*+,*%,? C-4%D 1 (proctitis) 4%D %1 !%
%
1 (distal colitis)
F=!'*+=%
corticosteroid aminosalicylate "4 @
mesalazine rectal suppo () A-+,*!"#
=4G3/ 0%'*+
" "4 %'% (enema) ,

'
'*+!'+% , 1
1 3 %F=!'*+ 4%D
'*+,*
, ?
" aminosalicylate & *%
@=*= 1 A-+ 1 3,*%,?
,1
corticosteroid ' %, %
" prednisolone () % 4-8 #
% / 0 % & ? %
3
=!
corticosteroid /!01*+1
21
11 3+I

! ' ''

!1
' !J4"%* !
% , % / 0 % '*+ , 1 1 3& 1
1 /='#F=!' / 0%

!"#
ciclosporin () (%& 8.2.2) (&
"
'*+, &-'!*) / 0%#'*+, 1
1 3,*4 !"#
azathioprine () (%& 8.2.1) ! mercaptopurine () (%& 8.1.3) ( / )

methotrexate () #! (%&
10.1.3) (', &
" '*+, &-'!*)
metronidazole () (%& 5.1.11) ,*!"#
3# '*+ 4 / !,*

'%

& 0.6-1.5 ,/%
%! 2-3 14!

14 1 1
1 , 4 3 +*+1 4
!' % 1 '**"4 +
,
" ,*&
" (" 14 "
!
'*+,=>#'!? (fistula) !'*+4 &-
'%) !
" %?,=4+,%
&'**
@'*+,4 (overgrowth)

!"#$%&'&'*+& !
"',! '*+ ,* !"# ,
%? ,
!!&

aminosalicylate 1 ,*!"#

# % mesalazine () "4 4&-'!*
=+
" @ %
3!!%
% corticosteroids ''*+!,
" %?,
!!&*+,*& *,

'*+ ,*&A

azathioprine () (%& 8.2.1)
&
2-2.5 ,44,/4,/% (&
" '*+, &-
'!*) mercaptopurine () (%& 8.1.3)
& 1-1.5 ,44,/4,/% (&

" '*+
, &- '!*) %
B
1 /
"4
/ 0 % 11 ' "4 %
& '*+1+% '*+!? methotrexate () (%&

10.1.3) *'-+#D*'*+
, ,C
" azathioprine mercaptopurine
(&
" '*+, &-'!*)
methotrexate
& 15 ,44,/ #
0
%

4B '*+,*
/
,* (low-residue) 1,%,,!,
/ 0% %41 !1? !/ 0%
!!&

%**+'*+,*
/!1
"
@ (%& 1.2)
/ 0%
'*+
4/
+%&
(" codeine ! loperamide) ! @
!1?
4 ,=1!B%!

= ,? 33'*+
,1?,% 1
" !,+ ,*B%! 1
%' %/* / A-,
* (" & @ %1
%) ' % colestyramine
() (%& 1.9.2) A-+L'>4M " %
*
!
3&40/+ !' (antibiotic
associated colitis - AAC)
AAC pseudomembranous colitis 4 =43
'*+ &- " Clostridium difficile

'*+=4+,%,&-
" J4"*%! *,
F=1 AAC
%,*+ & clindamycin ! lincomycin
1 J4"*%!''?"4 1
4 & *
* , 1 amoxicillin 3'*+,*%,!1
43
3 AAC

1 '**'
vancomycin () ( % & 5.1.7) metronidazole () ( % & 5.1.11) vancomycin
'*+,!,% '*+?,
1 ,506 (diverticular disease)
%4>*3 %#14/,! %4'*+
,*
/ 01 & !
&'&/!01
0 &"7 (antispasmodic) " %
'% F* ( % & 1.2) &5 !
"2++&
" F=!D*'*+,*14 "4 &-'
(% 1
='# F=!') /&1

! (" codeine, diphenoxylate
! loperamide) +'
*1% A-+
'
&4
sulfasalazine ()
mesalazine (mesalamine) ()
sulfasalazine () !& sulfapyridine
! 5-aminosalicylic acid (5-ASA mesalamine)
A-+ C/ ,'1# '* *

sulfapyridine ! 5-ASA

/!
'
5-ASA A-+L'>4MC-

4,D'*+/&- sulfapyridine -' '*+,
=! 5-ASA L'>4M4%D'*+,*
1 ,* %
4 & *=4,+ &- mesalazine
(5-ASA) () balsalazide (prodrug & 5-ASA) !
olsalazine (dimer & 5-ASA)
,
? ,*
A-+, ,*AR %! -, ,*& *
&AR 1 & *& 5-ASA "
( &/ %,
) / %,'
/ T (A-+ = sulfasalazine " * % )
mesalazine ,*=% sulfasalazine ,-,
" &'*+%
" ( /+&
" )
44

aminosalicylate

sulfasalazine

chronic inflammatory disease
rheumatoid arthritis

sulfasalazine

sulfasalazine
G6PD deficiency
kernicterus

aminosalicylate
sulfasalazine mesalazine

salicylate
aminosalicylate

(
)

(
eosinophilia fibrosing alveolitis)
(

methemoglobinemia)
( )
(
Steven-Johnson syndrome)
SULFASALAZINE
Tab 500 mg 4.09

EC tab 500 mg 6.25
chronic
inflammatory bowel disease
(ulcerative
colitis)

(maintenance of remission)
(active Crohn's disease)
( 10.1.3)

(US Pregnancy Risk Category B, ADEC
Category A)

digoxin (
digoxin) methotrexate (
) NSAID ()
( Reye's syndrome)

acetylation (slow acetylator)

3
3
( 9.8.2)

Prescription note

sulfonylurea, thiazide, furosemide
carbonic anhydrase inhibitor

6

( Heinz body anemia,
megaloblastic anemia) (
exfoliative dermatitis, toxic epidermal necrolysis
serum sickness)
()

(

) (
)

(ulcerative colitis) (active
Crohn's disease)

4
enteric-coated
tablet
45

500 2-4
1-2 3-4
(
corticosteroid )
500
4
6
40-60 / 3-6
20-30 /
4
2

10.1.3 Disease-modifying
antirheumatic drugs (DMARDs)
enteric-coated
MESALAZINE (MESALAMINE 5-ASA)

EC tab 250 mg 19.75 500 mg
34.35
Rectal supp 500 mg 112 1 g
200
1. sulfasalazine
2. ulcerative colitis
( sigmoid colon rectum) radiation
proctitis
(ulcerative
colitis)

(maintenance of remission)
46
(active Crohn's disease)

inflammatory bowel disease

(US Pregnancy Risk Category B, ADEC Category C)

3
6 4

digoxin ( digoxin) NSAID ( )
( Reye's
syndrome)

Prescription note
mesalazine
enteric-coated slow released
tablet

enteric-coated tablet
1

500 3
750-1,500
BNF
(British National Formulary)

1-3
rectal suppository 500
1-2 2-3 3-6

rectal suppository 1000
1 1 3-6

hydrocortisone sodium succinate ()
prednisolone ()
methylprednisolone sodium succinate ()
6.3
corticosteroid suspension

HYDROCORTISONE
Sterile pwdr (as sodium succinate) vial 100

mg (2 ml) 50
6.3

(regional enteritis)
100-500
2, 4 6
0.666-4 ()//
20-120 ()/
2/ 12-24

30 100
500
10

PREDNISOLONE
Cap/Tab 5 mg 0.25
6.3

(regional enteritis)
5-60 /
3-4
0.5-1.7 // 5-25 /
2/ 6-12

METHYLPREDNISOLONE
Sterile pwdr (as sodium succinate) vial 40 mg

(1 ml) 182 vial 125 mg (2 ml)
47
368 vial 500 mg (8 ml)

1,388 vial 1000 mg (16 ml)
2,560
Sterile susp (as acetate)
6.3
methylprednisolone acetate susp

10-120
0.5-1.7 / / 5-25
/2/ 6-12
methylprednisolone sodium succinate sterile pwdr
10-40
(
IM IV)
0.5-1.7 / / 5-25
/2/ 6-12

3-15

2 / 250

30

infliximab
infliximab monoclonal antibody (IgG)
pro-inflammatory cytokine tumor necrosis
factor alpha (TNF alpha)
48

anaphylactic
shock

(food allergy)

( )

food intolerance
(IBS) sodium
cromoglicate (sodium cromoglycate)

49
1.6
(laxative)
1.6.1
1.6.2
1.6.3
1.6.4
1.6.5
(bulk-forming laxative)
(stimulant laxative)
(fecal softener)
(osmotic laxative)
(bowel preparation)
.. 2551
Laxatives
1. Bisacodyl
EC tab, rectal supp
2. Castor oil
oil
3. Glycerol
rectal supp
4. Senna
tab
5. Magnesium hydroxide
susp, susp (hosp)
6. Magnesium sulfate
mixt, mixt (hosp), sol, sol (hosp)
7. Sodium phosphates
enema
100 ml
- Sodium biphosphate
- Sodium phosphate
8. Lactulose
15.2 - 16.8 g
5.7 - 6.3 g
syr

hepatic encephalopathy chronic constipation 6

9. Macrogols (Polyethylene glycol,
PEG) with electrolytes
oral pwdr (hosp)
50
1.6 (laxative)
10. Sodium phosphates
oral sol
5 ml
- Sodium biphosphate
0.9 g
- Sodium phosphate
2.4 g

1. 45 24
2.

(abuse)

lactulose () methylcellulose
senna ()

macrogols

(
1.6.5)
senna

( )

lactulose
bisacodyl senna


ispaghula husk
methylcellulose
sterculia

(colostomy)
(ileostomy)
(anal fissure)

(IBS) (adjuncts)
(ulcerative
51
colitis) ( 1.5)

ispaghula husk, methylcellulose

sterculia
methylcellulose

ispaghula husk US
pregnancy Category C

12
1 ( ispaghula husk 3.5 )


bisacodyl ()
castor oil ()
glycerol ()
senna ()
docusate sodium
bisacodyl () senna () anthraquinone dantron (danthron) dantron
(
)
(genotoxicity)
52
cascara ( anthraquinone )
() (obsolete)
docusate sodium
(atonic non-functioning colon)

(
BISACODYL)

( 1.6 )
(glycerol suppository) ()

parasympathomimetic
pyridostigmine () neostigmine () bethanechol
distigmine ( 10.2.1)
parasympathetic

BISACODYL
EC tab 5 mg 0.14
Rectal supp 10 mg 7.50

(US Pregnancy
Category C, ADEC category A)

6

1

(physiological dependence)
16

(toxic megacolon)

1
6-8
1.6

12 5-10
53
6-11 5
15-60
1.6

12 10
3-11 5-10
1-3 5

12 10-15

10
6-11 10
5

(

)

12 15-60
1
4
CASTOR OIL
Oil
castor oil

(US Pregnancy
Category X, ADEC Category )

(cathartic
colon)
GLYCEROL (GLYCERIN)
Rectal supp 2.50 (

)

BISACODYL
2007 US FDA
diethylene glycol (DEG)
glycerol
DEG

glycerol
DEG glycerol
54
1
( )
1 (1 )
1 (2 )
(4 )
1 gelatin 140
glycerol 700
1 15-30
SENNA
Tab 1.00
senna

(US Pregnancy Category ,
ADEC Category A)

6

1 sennoside A
B sennoside B 7.5
8-12
1.6

12 2-4

6-11 1-2
liquid paraffin
(liquid paraffin)

granulomatous reaction lipoid pneumonia

3 (bulk laxative)
( 1.6.1) non-ionic
surfactant docusate sodium ( 1.6.2)


magnesium hydroxide ()
magnesium sulfate ()
lactulose ()
macrogols

(purgative) magnesium hydroxide ()

magnesium hydroxide () magnesium
sulfate ()
lactulose ()

(hepatic
encephalopathy)
48
macrogols ethylene
glycol (polyethylene glycol - PEG)
macrogols

3000
3350 4000
( macrogols with electrolytes 1.6.5)
55
MAGNESIUM HYDROXIDE
Susp 400 mg/5 ml (240 ml) 15

Susp (hosp) 75
mg/ml

(
) (
)

20 (162 /
48 )

(US Pregnancy
Category B, ADEC Category )

2

1.1.1
gabapentin, phenothiazine,
phenytoin, quinidine, quinolone, rosuvastatin
tetracycline lactulose
methenamine

56

sepsis
400 /
5

12 15-60
6-11 15-30
2-5 5-15
2 (
) 0.5-3 /
MAGNESIUM SULFATE
Mixt, Mixt (hosp)

400 mg/ml
Sol, Sol (hosp)
500 mg/ml
magnesium sulfate

MAGNESIUM HYDROXIDE

MAGNESIUM HYDROXIDE

MAGNESIUM HYDROXIDE
( 2-4
)
5-10
LACTULOSE
Syr 66.7 % (10 g/15 ml) (120 ml) 76

Syr 66.7 % (10 g/15 ml) (1000 ml)
590
hepatic
encephalopathy / chronic constipation
6
(hepatic encephalopathy portal systemic

encephalopathy - PSE)
6

(US
Pregnancy Category B, ADEC Category )

6
1.6.5 (bowel preparation)

lactulose magnesium hydroxide

lactulose

(intolerance)
(galactose 2.2 /
lactose 1.2 / )

66.7% (10
/ 15 )

30-45 (20-30 lactulose)

3-4
2-3
30-45
40-90 (27-60
lactulose) 3-4
1-2 2-3

2.5-10 (1.67-6.67
lactulose) 3-4
2-3
57

24-48
15-30 1
60
( 1.6 )
5-10 10 2
1-5 5 2
1 2.5 2
1.6.5
(bowel preparation)
sodium phosphates enema ()
sodium phosphates oral solution ()
macrogols with electrolytes (polyethylene
glycol - PEG with electrolytes) ()
sodium
phosphates enema ()

sodium
phosphates oral solution ()

macrogols with electrolytes (polyethylene
glycol - PEG with electrolytes) ()
(colon cleansing)

(high-volume gut lavage)
mannitol
PEG with electrolytes

sodium phosphates

58
SODIUM PHOSPHATES ENEMA
Enema 133 ml 37 /
100
sodium phosphate 5.7-6.3 sodium biphosphate
15.2-16.8

(bowel preparation)

(133 )
(
)
SODIUM PHOSPHATES ORAL SOLUTION
1.6
12 118
3-12 59
59

15

2-5
SODIUM PHOSPHATES ORAL SOLUTION
Oral sol 90 ml 79 /
5
sodium phosphate 2.4 sodium
biphosphate 0.9 12.45 /
phosphate, 4.82 /
sodium 4.15 /
phosphorus
1. 45 24

2.

(bowel preparation)
()
(
)

(CrCl < 30 /)
(

)
(US Pregnancy Category C, ADEC
Category )

QT
prolongation Class IA antiarrthythmic
(procainamide, quinidine), Class III antiarrthythmic
(amiodarone), chloroquine, clarithromycin,
erythromycin, halofantrine, haloperidol, pentamidine,
phenothiazine (chlorpromazine,
thioridazine), pimozide, terfenadine
aminophylline, bupropion, corticosteroid,
haloperidol, phenothiazine, tramadol, theophylline,
tricyclic antidepressant, pimozide

ACEI

3

QT prolongation

59

unstable angina
pectoris

5

45 24

angioedema

15 1,668
90
1 45
30
6
""

()
12 20
45 24
10-11 10
20 24
5-9 5
10 24
60
1 (240 )

3 1
MACROGOLS WITH ELECTROLYTES (POLYETHYLENE GLYCOL-PEG WITH ELECTROLYTES)
oral pwdr (hosp) PEG 4000 5.5

potassium chloride 0.07 sodium bicarbonate
0.17 sodium chloride 0.15 sodium
sulfate 0.57
polyethylene glycol

1 PEG 10 1
PEG 137.155

(US Pregnancy

( ulcerative colitis
toxic megacolon)
(asystole)

(>10%) (malaise)

(rigor) (1-10%)

1 100

2 (
)
3-4

1 4

200-300
10-15
3-4
6 25
//
20-30 /
(1.2-1.8 /)
61
1.7
1.7.1
1.7.2
1.7.3
1.7.4
(local preparation for

anal and rectal disorder)
(soothing hemorrhoidal preparations)
(compound hemorrhoidal preparations
with corticosteroid)
(rectal sclerosant)
(management of anal fissure)
.. 2551
Local preparations for anal and rectal disorders
1. Local anesthetic + Corticosteroid
(with/without astringent)
cream, oint, rectal supp

1. 1
2. 7

(ointment) (suppository) ( 1.7.1)
(fistula) (proctitis)

(fecal
soiling)
(
1.6.1)
sulfasalazine ( 1.5)

( 1.7.1) ( 1.7.2)

nystatin ()
( 5.2 7.2.2
13.10.2)
(anal
fissures) 1.7.4
1.7.1
(soothing hemorrhoidal preparations)
local anesthetic + astringent
bismuth subgallate, zinc oxide, titanium

dioxide, hamamelis

62
1.7.2 (compound hemorrhoidal preparations with corticosteroid)

lidocaine (lignocaine)
( 15.2)

tetracaine
(amethocaine), cinchocaine pramocaine
(pramoxine)

( 7 )

1.7.2
(compound hemorrhoidal preparations with corticosteroid)
local anesthetic + corticosteroid (with/without
astringent) ()

13.4
1.7.1
LOCAL ANESTHETIC + CORTICOSTEROID

(WITH/WITHOUT ASTRINGENT)
Cream fluocortolone pivalate + lidocaine

hydrochloride (10 g) 67.41
Oint hydrocortisone acetate + benzocaine +
zinc oxide (10 g) 45.49
Rectal supp fluocortolone pivalate + lidocaine
hydrochloride 4.9 / hydrocortisone acetate + benzocaine + zinc oxide
4.8 /
1. 1
2. 7
/
(anal
fissure)
()

(US Pregnancy Category C, ADEC Category )

amide,
paraben, sulfites tartrazine

1.7.3 (rectal sclerosant)
methemoglobinemia
COPD
G6PD
()

()
()

(angioedema )
)
(
)
methemoglobinemia
( )
1-2
7

1
1-2
7

63
1.7.3 (rectal
sclerosant)
phenol
phenol (oily phenol injection)

phenol
1.7.4 (management
of anal fissure)

( 1.7.1)

( glyceryl trinitrate 0.4% ointment)
64
1.8
(stoma care)
(
)

(modified release)

( 1.6.1)
senna ( 1.6.2)
loperamide, codeine phosphate co-phenotrope (diphenoxylate +

atropine Lomotil)

potassium sparing diuretic ( 2.2.3)
digoxin
digoxin
potassium sparing diuretic ( 9.2.1.1)

()
opioid ( 4.7.2)

opioid
paracetamol

( 9.1.1.2)
65
1.9
(drug affecting intestinal secretion)
1.9.1
1.9.2
1.9.3
1.9.4
(drug affecting biliary composition and flow)

(bile acid sequestrant)
(pancreatin)
.. 2551
Drugs affecting intestinal secretions
1. Colestyramine (Cholestyramine)
oral pwdr

bile-acid diarrhea short bowel syndrome
2. Ursodeoxycholic acid (Ursodiol)
cap

1. cholestatic liver disease primary biliary cirrhosis, sclerosing cholangitis, biliary
atresia, neonatal hepatitis, drug-induced chronic cholestasis TPN-induced cholestasis
2.
3. Pancreatic enzymes
lipase activity
1,200 USP units/cap tab
cap, tab, EC cap, EC tab

pancreatic insufficiency
1.9.1 (drug
affecting biliary composition and flow)
ursodeoxycholic acid (ursodiol) ()
ursodeoxycholic acid (ursodiol)

ursodeoxycholic acid
(<10% )
66
1.9.1 (drug affecting biliary composition and flow)

(< 1 )

ursodeoxycholic acid
()
(
)

1
25 5
50

( )
ursodeoxycholic
acid primary
biliary cirrhosis (PBC)

primary sclerosing
cholangitis (PSC), drug-induced TPN-induced
cholestasis, biliary atresia, neonatal hepatitis
( )

intrahepatic cholestasis of
pregnancy (ICP), non-alcoholic steatosis-hepatitis
(NASH)
( )
URSODEOXYCHOLIC ACID (URSODIOL)

Cap 250 mg 12
1. cholestatic liver disease primary

biliary cirrhosis, sclerosing cholangitis, biliary
atresia, neonatal hepatitis, drug-induced chronic
cholestasis TPN-induced cholestasis
2.

(US pregnancy category B,
ADEC Category )

ciclosporin,
activated charcoal, cholestyramine fibric acid
derivative ( clofibrate)

(radiopaque stone)
(calcified
cholesterol stone)
(bile pigment) (
) (nonfunctioning gall bladder)

(

1.9.1 (drug affecting biliary composition and flow)
primary biliary cirrhosis (PBC)

13-15 / 2-4

ursodiol

primary sclerosing cholangitis (PSC)

( )
(
)
13-15 / 2-4
LFT

ursodiol

13-25
/
biliary atresia
(
)

10-20
67
/
40 /
biliary atresia
TPN-induced cholestasis (

)

13-15 /
2-4
(extemporaneous preparation)

ursodiol
60
/
3.6 (mortar)
glycerin USP 10
simple syrup USP 60
""
35 ( 4
)
terpene (pinene, camphene, cineol,

menthone, menthol, borneol olive oil)

68

colestyramine (cholestyramine) ()
colestyramine (cholestyramine) anionexchange resin

colestyramine
colestyramine
(
LDL) ( 2.12)
COLESTYRAMINE (CHOLESTYRAMINE)
Oral pwdr sachet (4 g) 25
bile-acid
diarrhea short bowel syndrome
short bowel syndrome (

)

()
( 2.12)
COLESTYRAMINE 2.12
COLESTYRAMINE 2.12
COLESTYRAMINE 2.12
()
2-4 1-4
(2-8 )
3-4
4-24
1-4 (
) 24

4 1-2 ( 4-8 )
()
16

1 4-6
1.9.3
aprotinin hemostatic
cardiopulmonary
bypass
( )
1.9.4 (pancreatin)
1.9.4 (pancreatin)
pancreatic enzyme ()
pancreatin
pancreatin
cystic fibrosis

( )
pancreatin
(amylase) (lipase)
(protease)
pancreatin
(
)
ranitidine omeprazole
1 ( 1.3) antacid

(
)

( )
(strength)

PANCREATIN

69
PANCREATIN
Cap, Tab
EC cap, EC tab lipase 1600
USP unit tab 1.22
lipase
activity 1200 USP unit

pancreatic insufficiency
pancreatic insufficiency ( cystic fibrosis,

chronic pancreatitis, pancreatectomy gastrectomy)

(US Pregnancy

(fibrosing colonopathy)
2-13 ( cystic fibrosis)

2-8

calcium (
calcium carbonate) magnesium ( magnesium
hydroxide) pancreatin
alpha-glucosidase
inhibitor ( acarbose, voglibose)
pancreatin pancreatin

()
70
1.9.4 (pancreatin)
(
)
(

)

pancreatin

pancreatin

pancreatin
simeticone
(
)
1-2
1
( )

5-15
pancreatin

8000 USP
lipase 17
lipase Combizym
Compositum coated tab lipase 1350 USP
Creon 10000 cap lipase 1333 USP
lipase
1350 USP
71
16
C Urea breath test (13C-UBT)
5-ASA see Mesalazine
Acetorphan see Racecadotril
6
Acid neutralising capacity (ANC)
32
Acute diarrhea
32,35
Adsorbent
8,35
- Activated charcoal
33,35
- Dioctahedral smectite
4,8,33,35,39
- Kaolin
33,35,39
- Pectin
4
Alkalosis
1,3,6,7
Aluminium hydroxide + Magnesium
hydroxide
1,3,7
Aluminium hydroxide + Magnesium
hydroxide + Simeticone
Aluminium
1,3,4,21,35
- Hydroxide
13
Alverine citrate
41,42,43
Aminosalicylate
Anesthesia
- Local
- rectal
62
- lidocaine (lignocaine)
62
- tetracaine (amethocaine)
62
- cinchocaine
- pramocaine (pramoxine)
62
51,61,62,63
Anal fissure
68
Anion exchange resin
Antacid
3
- aluminium
3
- bismuth
13
4
- calcium
3
- magnesium
4
- simeticone and
3
- sodium
51
Anthraquinone
35,43
Antibiotic associated colitis (AAC)
32,34,35
Antimotility drug
9,10,14,21
Antimuscarinic
35,39
Antisecretory agent
9,13,34,41,43
Antispasmodic
68
Aprotinin
61,62
Astringent
61
- Bismuth subgallate
61,62
- Zinc oxide
61
- Hamamelis
61
- Titanium dioxide
52
Atonic non functioning colon
10
Atropine sulfate
42
Azathioprine
43
Balsalazide
2
Barrett's esophagus
52
Bethanechol
21,22
Bezoar
65,68
Bile acid diarrhea
65,68
Bile acid sequestrant
Biliary atresia
65,66,67
4,49,51,52
Bisacodyl
3,28,33,35,39
Bismuth subsalicylate (BSS)
49,57,58
Bowel preparation
32,35
Bulk-forming agent
34
Campylobacter enteritis
72
28
Carbenoxolone
52
Cascara
49,51,53
Castor oil
34
Ceftazidime
34
Cefotaxime
14,21
Chelate and complex
Cholestasis
65,66
- drug induced
- TPN induced
65,66,67
Cholestyramine see Colestyramine
Chronic bowel disorders
41
Chronic constipation
49,56
Ciclosporin
42
Cimetidine
18,19
Ciprofloxacin
33
Cisapride
10,14
Clindamycin
43
Clidinium
10,11
Clostridium difficile
43
Codeine phosphate
33,64
Colestyramine
35,43,65,68
Colistin
33
Colitis
- antibiotic associated (AAC)
35,43,60
- ulcerative
11,41,42,44,45,51,60
Colostomy
35,51
Compound cardamom mixture
1,8,9
Co-phenotrope
34,64
Corticosteroid
41,42,46,61,62
Cox II inhibitor
17,18
Crohn's disease
42,44,45,46
Cytokine inhibitor
41,46,47
Dantron
51
Diarrhrea
- Acinetobacter
34
- E.coli
- Pseudomonas
Dicyclomine see Dicycloverine
hydrochloride
Dicycloverine hydrochloride
Diethylene glycol (DEG)
Diiodohydroxyquin
Diphenoxylate
Distal colitis
Distigmine
Diverticular disease
Docusate
- sodium
Domperidone
Dopamine receptor antagonist
Drotaverine
Duodenal ulcer or Gastric ulcer
- NSAID associated
- associated with H.Pylori
Dyspepsia
- nonulcer
- ulcer
Encephalopathy
- hepatic
Enkephalin
Enkephalinase
Enterotoxin
Esomeprazole
Esophageal varices
Famotidine
Fecal soiling
Fenoverine
Fenpiverinium
Flatulence
Food allergy
Furazolidone
33
33
9,10,12
53
33,39
34,35,43,64
42
52
43
51,52,54
9,10,14
10
13
17,18
17
1,4,7
3,14
3
49,55,56
35
35
35
23
30,31
18
61
13
13
4,7,9
48
33,39,40
G6PD deficiency
Gastro enteritis
Gastro esophageal reflux disease
(GERD)
Gentamicin
Glucagon
Glycerol
Helicobacter pylori
Hemolytic uremic syndrome
Hemorrhoid
Hydrocortisone
- sodium succinate
Hydroxypolyethoxy dodecane see
Lauromacrogol 400
Hyoscine butylbromide
Hyperphosphatemia
Ileostomy
Infliximab
Inflammatory bowel disease
Intrahepatic cholestasis of
pregnancy (ICP)
Invasive salmonellosis
Irritable bowel syndrome (IBS)
Ispaghula husk
Kernicterus
Lactulose
Lansoprazole
Lauromacrogol 400
Laxatives
- bulk forming
- stimulant
- fecal softener
- osmotic
Lipase activity
Liquid paraffin
44
34
1,2
34
29
49,51,52,53
14,18
15,16,17,20
33
15,61,62
46
10,11,12
4
35,51
47
41,42,44
66
33
41
51
42
49,50,55,56
23
15,29
32,35,49,51
49,51
49,54
49,55
65,69
54
73
Local anesthetic + Cortiosteroid

62
(with/without astringent)
Loperamide
- hydrochloride
32,33,34,35,36,39,41,43,64
Macrogols with electrolytes
55,57,60
Magnesium
- hydroxide
3,49,55
- sulfate
49,55,56
Malabsorption syndrome
41
Mebeverine hydrochloride
10,13
Mendelson's syndrome
18
Mercaptopurine
42
Mesalamine see Mesalazine
Mesalazine
41,42,43,45
Methotrexate
42,43
Methylprednisolone
- acetate
47
- sodium succinate
46,47
Methylcellulose
35,50,51
Metoclopramide
2,10,14
Metronidazole
15,16,17,28,42,43
Milk alkali syndrome
4
Mist carminative see Compound
cardamom mixture
Misoprostol
23
Monoclonal antibody
47
Neomycin
33,39,40
Neonatal hepatitis
65,66
Neostigmine
52
Neurotoxic
4
Nizatidine
18
Non - alcoholic steatosis 66
hepatitis (NASH)
Norfloxacin
33
Nystatin
61
74
Octreotide
- acetate
Oculogyric crisis
Oily phenol injection
Olsalazine
Omeprazole
- sodium
- suspension, simplified (sos)
Oral rehydration salts (ORS)
Oxyphencyclimine
Pancreatic enzyme
Pancreatic fistula
Pancreatic insufficiency
- Cystic fibrosis
- Chronic pancreatitis
- Pancreatectomy
- Gastrectomy
Pancreatin
Pantoprazole
- sodium
Parasympathomimetic
Peritonitis
Pirenzepine
Pitofenone
Polidocanol see Lauromacrogol 400
Polyethylene glycol (PEG) with
electrolytes see Macrogols with
electrolytes
Prednisolone
Primary biliary cirrhosis (PBC)
Primary sclerosing cholangitis (PSC)
Probiotic
Lactobacillus acidophilus
Bifidobacterium sp
Lactobacillus rhamnosus GG
29
14
63
43
14,23,24
14,27
26
32,36,37
10,11
65,69
15,29,30
65,69
69
69
69
69
41,65,69
23
15,27
52
34
21
13
42,46,47
65,66,67
66,67
35,39,40
39
39
40
Saccharomyces boulardii
40
Lactobacillus casei
40
Lactobacillus reuteri
40
Proctitis
42,45,61
Prokinetic drug
2,10
Propantheline bromide
10,11
Prostaglandin analogue
14,23
Proton pump inhibitor (PPI)
2,14,23
Pseudomembranous colitis see
Antibiotic -associated colitis
(AAC)
Pthalylsulphathiazole
33,39
Purgative
55
Pyridostigmine
52
QT prolongation
10
Quadruple therapy
16,28
Rabeprazole
23
Racecadotril
35,39
Ranitidine
18
- hydrochloride
14,15,19,20
- bismuth citrate
15,16,17,21,22
Ranitidine bismutrex see Ranitidine
bismuth citrate
Renal osteodystrophy
4
Rhabdomyolysis
13
Sclerosant
- rectal
61,63
Sclerotherapy
15
Scopolamine see Hyoscine
Senna
50,51,54,64
Shigellosis
34
Short bowel syndrome
65,68
Simethicone see Simeticone
Simeticone
1,3,4,7
Sodium cromoglicate
48
Sodium phosphates
- enema
57,58
- oral solution
57,58
Somatostatin
- acetate
15,29,30
Sterculia
35,51
Stoma care
64
Stress ulcer
20
Sucralfate
15,22
Sulfasalazine
41,42,43,44,59,61
Sulfonamide
33,40
Sulphasalazine see Sulfasalazine
Tiropramide
13
Travellers' diarrhea
32
Triple therapy
15,28
Tumor necrosis factor alpha (TNF)
47
Ulcer healing drug
14,28
Ulcerative colitis see Colitis
Ursodeoxycholic acid
65,66
Ursodiol see Ursodeoxycholic acid
Vancomycin
43
Variceal bleeding
15,29,30
Varicose vein
15
Vasopressin
29
Zinc
- sulfate
32,34,36,38
Zollinger-Ellison syndrome 18,20,24,25,26,28
1,2,14,18,20,25,27

13,27
,
51,53
,
41

64
48
-
20,21
75
20
-
4,5

10,13,35,43,51
41,50,51,52,53,54,55,56,57
-
68
-
32,34,35,36,39
-
36
34,51,60
51,52,53
,
57
33,34,37,38

- H.pylori
15,20,25
- NSAID
15,17,20,25
3,5
3,4,5,59
QT
10,29
51,54
9,13,34,41,43
65,68

35

2
14,18

9,10,21,33

49,57
61

14,23
-
43,49,51,61,64
-
49,51
76
-
-
,
-
-
,
49,54
49,55,57
1,3
33,35
42,45,46,47,48
66
10,12,13,41,43,48
42,44,45,46
43
52
14
29
51

51,54
50,51,54,61,62,63

55,56
51,64
32,35,40
29
34,36

32,35
61

52,53,54

-
3,6
-
3,6
61

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1

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