消化系統藥物

[F]: 消化系統藥物 (胃腸肝膽科)

Drugs for peptic ulcer

制酸劑
Polymerized Al(OH)3 hexitol complex
Ulcerin P (233mg) Al(OH)3		1-2# t-qid
Strocain	Oxethazine (5) Polymigel Al(OH)3, CaCO3, MgCO3 (244)	1-2# t-qid
Ulstal (10ml/pk)
Kolantyl (1g/#)	Dicyclomine (5), MgO (200), Al(OH)2 (200), simethicone (25)	1-2# t-qid
H2 blocker
Cimetidine	Defense (300)	3# hs or 1# t-qid x4-8wk
Ranitidine (150)	Quicran (150)	PUD, GERD: 1# bid; 2# hs; 維:1#hs Erosive esophagitis  1# qid, 維:1#bid; 2#hs
Famotidine	Gaster (20/amp)	1 amp iv q12h
PPI
Esomeprazole	Nexium (40/#, /vial)	PUD, GERD:   PO 20-40mg qd x 4-8wk H.pylori eradication,   PO 40mg qd stress ulcer預防   Iv 40mg qd GIB After EGD止血:   40mg iv q12h x3 d
Lansoprazole	Takepron (30)	H.pylori eradication,   PO 1# bid. GERD: 1# qd-bid
Pantoprazole	Pantoloc (40)	H.pylori eradication,   1# PO bid.
Rabeprazole	Pariet (20)	H.pylori eradication,   1# PO bid.
Site-protective drugs
Sucralfate	SUCA (1g/pk)	PUD: 1pk qid or 2 pk bid x4-8wk Oral ulcer: 1 pk/10ml水 swish qid Rectal ulcer: 2 pk/20ml水enema bid x12-60d
Colloidal bismuth subcitrate	KCB (300/# (120mg Bi2O3)	PUD: 1# qid, 2# bid x1-2m H.pylori: 1# t-qid
Others
Alginic acid	Topaal chewable tab:   Alginic acid 200mg, MgCO3 40mg, Colloidal Al(OH)3 30mg Alginos (210ml/bt)   Alginate Na (50), NaHCO3 26.7mg, CaCO3 16mg/ml)	1-4# t-qid; 10-20ml t-qid

Prokinetics

5-HT4 agonist/ D2-antagonist
Metoclopramide	Prometin (5) (PRIMP) Gastro-Timelets (30) (GT) Primperan (10mg/2ml/amp)	Stasis/GERD/nausea/hiccup:   PO 5-10mg (1-2#) t-qid      30mg, 1 cap qd   Iv, IM 10mg C/T induced嘔吐   急性嘔吐: iv (15-20mg) 1-2mg/kg, 化療30’前給 (pre-Tx with vena to↓EPS.   延遲性嘔吐: 10-40mg (0.5mg/kg), PO, iv, im, q6h Timelet 1-2 cap qd-bid x2-4d
D2-antagonist
Domperidone	Nidolium (10)	Gastroparesis, anti-emesis: 1-2# t-qid
5-HT4 agonist
Mosapride	Mopride (5)	1# tid

Anti-spasmodics

Anti-cholinergic
Dicyclomine	Bentyl (10)	1-2# tid-qid	[副]: ileus,尿滯留,心悸 c/i: ileus, 潰瘍性結腸炎, obst uropathy
Scopolamine	Buscopan (10/#) Fucon (20/amp)	腸/尿道絞痛: 1-2# tid-qid 1 amp PRN (IM, IV, SC)
Mepenzolate	Trancolon (7.5)	IBS: 1-2# tid
Ca channel antagonist on GUT
Pinaverium	Spastec (50)	IBS, GI spasm: 1# tid-qid
Peppermint oil	Menthol oil	腹絞痛,脹氣; 止痛,鼻塞
Muscarinic/ Ca/ tachykinin blocker
Otilonium Br.	Catilon (40)	IBS, spastic pain: 1# bid-tid

Cathartics

Stimulant laxatives
Castor oil	Castor oil	檢查前bowel cleaning: 30-60ml	忌孕婦 (引早產)
Sennosides	Sennapur (12.5)	1-4# hs (max: 6-8#/d)
Bisacodyl	Dulcolax (5/#) Bisacodyl (10/supp)	PO: 1-4# hs; 嚴重: 2-3# b-tid Supp: 1 supp qd-bid	勿長期用
Isosmotic laxative
GI klean /pack	Polyethylene glycol 3350 (59g) (non-absorbable) Sod sulfate anhydrous Sod bicarbonate NaCl: 1.465g  KCl 0.7425g Aspartame 0.0494g	便秘: 1/4-1/2 pk qd-bid Bowel cleaning: 2-4 pk (onset: 1-2h)   前一天PM 1-2 pk   隔天AM 1-2 pk  (每包加水1L, PO 250ml q10-15’; NGT: 20-30ml/min)
Hyperosmotic laxative
Lactul syrup (60ml/bt)	Lactulose 67%, lactose 6%, galactose 11%	Pre-exam: 30-60ml (onset 2-3h) 便秘: 15-30ml qd-qid 肝昏迷:  PO: 15-30ml bid-qid (調整至2次半軟便/day)  快速Laxation:    PO: 30-45ml q2-3h,直到bowel mvt    肛門: 250-300ml + N/S到700ml, q6-12h (retain 30-60’)
Magnesium oxide	MgO (250) (1#: Mg 150mg, 12.3mEq)	便祕, 低血鎂: 1-2# b-tid Mg富含於:  Spinach(菠菜=1cup: 157mg), 豆類beans/peas, 堅果nuts/seed, 全穀(未精製)類
Fleet phospho-soda	45ml/bt   Phosphorus (640mg/5ml),   Phosphate 62.25 mEq/5ml Na 556mg/5ml Monobasic sod phosphate 480mg/ml Dibasic sod phosphate 180mg/ml	低血磷: 5ml bid (水稀釋) 便秘: 15-45ml/d Pre-exam:   早上檢查: 前一天6:00pm 1 bt            隔天6:00 am 1 bt   下午檢查: 前一天7:00pm 1 bt            隔天7:00 am 1 bt	C/I: GFR < 60, CHF, 腹水 [副]: 高磷,低鈣
Fleet enema (低磷)	133 ml/bt  Mono-sod phosphate 160mg/ml  Di-sod phosphate 60mg/ml	便秘, bowel cleaning   1 Bt	小心:GFR <60, atonic colon, 一次二瓶 [副]: 高磷,低鈣
Evac enema	118 ml/bt  Mono-sod phosphate 139mg/ml  di-sod phosphate 31.8 mg/ml	1 bt	[副]: 高磷,低鈣
Bulking-forming laxative
Normacol Plus	7g /sachet (包) +500ml水   Sterculia 4.34g (62%)刺梧桐膠   Frangula 0.56g (8%)歐鼠李	1-2 sachet qd-tid	有助減肥 勿於入睡前吞服

Anti-diarrheal drugs

Loperamide	Imolex (2mg/cap)	1-2 cap t-qid
Dioctahedral smectite	Smecta (3g/sachet)	1-2 sachets tid	+ 30-50ml水/果汁 Smecta透過獨特片狀結構及高黏塑性與腸胃道黏膜緊密結合；同時可吸附及固定多種細菌、毒素、病毒、攻擊因子與發酵氣體等，於有效止瀉同時達到保護腸胃黏膜的作用。

Hepato-biliary agents

Flopropione	Cospanon (40/cap)	緩解膽道/胰臟炎相關spasm  1-2# tid
Ursodeoxycholic acid (Urso)	Cisbile (300/cap)	改善肝功能, PBC (primary biliary cirrhosis), 溶解radiolucent膽結石:  1# b-tid
Silymarin	Silymin (150/cap)	1-2 cap b-tid
SN-M C (Stronger Neo-minophagen C)  20ml/amp	Glycyrrhizin 2mg  Aminoacetic acid 20mg  L-cysteine 1mg/ml	改善肝功能,過敏   2-5 amp iv qd x7d -> tiw-qwk	-Immunomodulator,抗發炎/過敏 -可稀釋in N/S, D5W or不稀釋 -[副]: pseudo-aldosteronism (低血鉀, edema)

其它腸道用藥

Mesalamine (mesalazine) =5-aminosalicylic acid	Asacol (800/#) Asacol (500/supp) Colasa (2g/100ml/enema)	UC, Crhon’s dz:  PO: 1-2# tid; 維: 1# qd-bid  Supp: 1-2 supp hs-tid  Enema: 1-2 bt hs
Hydrocortisone	Cortema 100mg/60ml/enema	UC: 1 bt hs
Dimethylpolysiloxane	Kascoal (40/#) Wilcon drop (20mg/ml, 300ml/bt)	消脹氣: 1-2# t-qid 胃鏡, X-ray exam前消gas or foamy mucus: 15-40’前
Biofermin S	Lactobacillus 2mg Bifidobacteria 2mg Streptococcus faecalis 2mg	1-3# tid
Infloran (250/cap)	Bifidobacterium bifidum 24mg (109 cfu) Lactobacillus acidophilus 24mg(109 cfu)	1 cap t-qid, prn
Clostridium butyricum miyari	Miyarisan BM (40mg/1g/pk)	1-2 pk tid
Protase	Lipase (20,000U) + protease (75,000U) + amylase (66,400U)	胰臟Insufficiency: 1 cap tid