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Emergency Gastrointestinal Drugs
Related Subjects: |Emergency Drugs |Emergency Drug Antidotes |Emergency Cardiac Drugs |Emergency Endocrine Drugs |Emergency Gastrointestinal Drugs |Emergency Haematology Drugs |Emergency Neuropsychiatric drugs |Emergency Pain drugs |Emergency Respiratory drugs |Emergency Obstetric and Gynaecology Drugs |Emergency Paediatric Drugs
Check all doses with BNF or equivalent UK guidelines
| DRUG | MOA | DOSE IV | DOSE PO | INDICATION | CONTRAINDICATION / CAUTION |
|---|---|---|---|---|---|
| Droperidol | Dopamine receptor antagonist and alpha receptor antagonist | 1.25–2.5 mg IV every 4 hours PRN | N/A | Antiemetic, migraine-associated nausea | QT prolongation (risk of Torsades), NMS, EPS; refer to BNF for use in pregnancy |
| Esomeprazole (Nexium) | Proton pump inhibitor (inhibits parietal cell H+/K+ ATPase) | 80 mg IV bolus, then 8 mg/hour infusion (check local protocol) | N/A | Upper GI bleed (non-variceal) | Generally well tolerated acutely; refer to BNF for pregnancy advice (commonly considered relatively safe) |
| Metoclopramide | Dopamine (D2) receptor antagonist in chemoreceptor trigger zone, also enhances gastric motility | 10 mg IV every 6 hours PRN | N/A | Prevention and treatment of nausea and vomiting | Risk of tardive dyskinesia, EPS, dystonia; use short-term. Check BNF for pregnancy guidance (often used if indicated) |
| Octreotide | Somatostatin analogue; reduces splanchnic blood flow and portal pressure |
Bleeding varices: 50 micrograms IV bolus, then 50 micrograms/hour IV infusion
Sulfonylurea toxicity: 50 micrograms subcut every 6 hours PRN |
N/A | Bleeding oesophageal varices, sulfonylurea-induced hypoglycaemia | May precipitate biliary stasis/gallstones; check BNF for pregnancy advice |
| Ondansetron | 5-HT3 serotonin receptor antagonist (centrally acting antiemetic) | 4–8 mg IV every 4–6 hours PRN | N/A | Prevention and treatment of nausea and vomiting | QT prolongation (rare risk of torsades); consult BNF for pregnancy use (commonly used if benefit outweighs risk) |
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