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Golden Points



  1. Apomorphine is used to produce vomiting in poisoning via parenteral route, while ipecacuhana via oral route
  2. Induction of vomiting is contraindicated in kerosene poisoning, acid & alkali poisoning-due to fear of aspiration and perforation
  3. Metochlopramide is MC used antiemetics but is D2 blocker, therefore causes hyperprolactinemia, and extrapyramidal side effects. It is DOC for aspiration pneumonitis (Also called as Mendelson’s syndrome).
  4. Domperidone blocks D2 receptors only in CTZ center & not in basal ganglia, therefore does not cause EPS (can even be used in Parkinson patients)
  5. Cisapride is a promotility (prokinetic or motility enhancing) drug with no antiemetics activity
  6. Cisapride given with enzyme inhibitors such as erythromycin, azoles, ciprofloxacin can cause torsa de depointes
  7. Mosapride, itopride etc are free from torsades depointes effect
  8. Cimetidine is the oldest and most toxic H2 blocker (causes gynecomastia & taste disturbances-dysgusia-ACE I also cause it)
  9. Ranitidine is free from gynaecomastia
  10. Antacids are fast acting anti-ulcer drugs but relapse rate is high-aluminum containing antacids cause constipation and intestinal obstruction
  11. Aluminum phosphate is used as a phosphate binder in CRF
  12. Magnesium oxide (milk of magnesia) cause diarrhea
  13. Omeprazole, rabeprazole, esomeprazole, pentaprazole etc drugs are PPIs and are DOCs for all acid related conditions (e.g. dyspepsia, ulcers, reflux esophagitis, Zollinger Ellison’s syndrome)
  14. They are safe drug and MC side effect is hypergastreniemia
  15. Misoprostol (PGE1) is an ulcer protective drug; previously, it was DOC for NSAID induced ulcers now PPIs are DOCs
  16. Bismuth subcitrate, deglycerinnized liquorice (has mineralocorticoid effect aldosterone like effect) are ulcer healing drugs; bismuth has anit-H.Pylori activity but can cause encehpahlopathy & osteodystrophy
  17. Metronidazole, clarithromycin\ampicillin\PPI are combination therapy (triple therapy) for eradication of H. Pylori
  18. Loperamide (a synthetic opioid-LOMOTIL) is the DOC for functional diarrhea (non-infectious-e.g. travelers diarrhoea)-it is free from disadvantages of opioids e.g. respiratory depression as it doesn’t enter BBB
  19. Diphenoxylate (Lomofen) is combination of atropine + Loperamide
  20. Physillium, bran are bulk laxatives-form bulk induce laxative effect
  21. Lactulose is osmotic laxative-used in hepatic encephalopathy
  22. PEG (polyethylene glycol) solution is used to clean bowel for colonoscopies
  23. Colistipol\cholestyramine are used for bile acid induced diarrhea
  24. DOSSS (dictylsodium sulphosuccinate) is detergent like drug for used for softening stool-bisacodyl also has similar effect
  25. Cotrixmoxazole\fluoroquinolones are antibiotics used in Shigella dysentery;otherwise antibiotics are avoided in diarrheas
  26. Daptomycin (Protein synthesis inhibitor), tigecycline (Antibiotic of tetracycline class), delbavancin (long acting antibiotic), vancomycin, linezolid, teichoplanin, cotrimoxazole, ciprofloxacin, streptogramins (dalfoprisin+quinupristin) ceftipiribole (5th generation cephalosporin) are antibiotics against MRSA. 

Recent Advances - Newer Drugs

Nitazoxanide (antiprotozoal agent)

Cryptosporidiun parvum

Tegaserod (5- HT4 antagonist)

Irritate bowel syndrome with constipation

Mesalamine (anti-inflammatory)

Active ulcerative procititis

Rifaximin (Antibiotic)

E. Coli diarrhea

Racecadrotil (Encephalinase inhibitor)


Lubiprostone (locally acting ClC-2 chloride channel activator)



Recent Advances:  GIT

Alvimopan: A peripherally acting mu opioid receptor antagonist.

Approved to accelerate the GIT recovery following bowel resection surgery.


Levosulpiride: Newer D2 blocker having prokinetic properties.

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