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Gastrointestinal Cocktail / GI Cocktail [1]
GI cocktail: Give to a patient who is symptomatic during the visit. If the patient responds to it, you know the source of their pain is the stomach
Responding to it with almost complete resolution of the pain indicates a gastric source for the pain.. There are many different concoctions of the GI cocktail.
Donnatal = Atropine / Hyoscyamine / Phenobarbital / Scopolamine. This one is available on formulary in our hospital.
What to Know About GI Cocktails [2]
A gastrointestinal (GI) cocktail is a mixture of medications used to treat indigestion. GI cocktails have also been used to treat symptoms of gastrointestinal problems such as chest and abdominal pain.
A GI cocktail is a mixture of medications that the Emergency Department (ED) often gives for symptoms of dyspepsia, also known as ingestion.. GI cocktails don’t have a specific set of ingredients since they can be made using different medications
The viscous lidocaine works as an anesthetic to relieve your pain, while the antacid neutralizes stomach acid to ease indigestion and heartburn.. An anticholinergic is added to treat vomiting, nausea, and other symptoms of gastrointestinal conditions
GI cocktail [3]
A gastrointestinal cocktail, (also known as a GI cocktail or gastric cocktail), is a mixture of medications used to treat symptoms of dyspepsia[1] The GI cocktail generally contains a mixture of viscous lidocaine, an antacid, and an anticholinergic.[1][2] The GI cocktail is commonly prescribed in the hospital or emergency department, and has been used to help distinguish chest pain as either gastrointestinal or cardiac.[1] While it has been widely used in the treatment of dyspepsia, studies have suggested that the GI cocktail is only as effective as antacids alone.[1]. The “GI cocktail” does not refer to a specific product
Anticholinergics work to ease symptoms that accompany dyspepsia including nausea, vomiting, and abdominal cramping.. The GI cocktail is a mixture of a viscous anesthetic, an antacid, and an anticholinergic.[1][2] Common viscous anesthetics use are viscous lidocaine or xylocaine
The GI cocktail is commonly prescribed in the hospital or emergency department to treat symptoms of dyspepsia.[4] These symptoms include: belching, heartburn, chest pain, abdominal discomfort, abdominal bloating, nausea, loss of appetite, and flatulence. Dyspepsia itself is not an illness, rather it is an indicator of chronic underlying gastrointestinal issues such as peptic ulcer disease, gastro-esophageal reflux disease, h.pylori gastritis, gastroparesis, or upper gastrointestinal cancers.[5][6] Dyspepsia can additionally be contributed to medications such as potassium supplements, NSAIDs, digitalis, iron, glucocorticoids, and colchicine, as well as lifestyle factors such as diet, stress, and cigarette smoking.[5][6]
How Long Does A G I Cocktail Last – Ward III [4]
A GI cocktail is a drink that is typically made up of a combination of an antacid and an anti-nausea medication. It is often used to help relieve the symptoms of stomach upset, heartburn, and indigestion
The answer to this question depends on the person’s individual reaction to the gi cocktail. Some people may feel hungry right away, while others may not feel the effects of the cocktail for a few hours
An antacid, lidocaine, and an anticholinergic called Donnatal are three of the most common ingredients in a GI cocktail. Irritability and associated symptoms are treated in emergency rooms and hospitals with this medication.
What to Know About GI Cocktails [5]
A gastrointestinal (GI) cocktail is a mixture of medications used to treat indigestion. GI cocktails have also been used to treat symptoms of gastrointestinal problems such as chest and abdominal pain.
A GI cocktail is a mixture of medications that the Emergency Department (ED) often gives for symptoms of dyspepsia, also known as ingestion.. GI cocktails don’t have a specific set of ingredients since they can be made using different medications
The viscous lidocaine works as an anesthetic to relieve your pain, while the antacid neutralizes stomach acid to ease indigestion and heartburn.. An anticholinergic is added to treat vomiting, nausea, and other symptoms of gastrointestinal conditions
GI Cocktail: Ingredients, Doses, Uses, Side Effects [6]
A gastrointestinal (GI) cocktail is a mixture of medications that you can drink to help ease the symptoms of indigestion. But what exactly is in this gastric cocktail and does it work? In this article, we take a look at what makes up a GI cocktail, how effective it is, and whether there are any side effects you should know about.
Instead, it refers to a combination of the following three medicinal ingredients:. This chart helps to explain what the GI cocktail ingredients are, why they’re used, and the approximate dose of each ingredient:
|liquid antacid||neutralizes stomach acid||Mylanta or Maalox||aluminum hydroxide, magnesium hydroxide, simethicone||30 mL|. |anesthetic||numbs the inside of the throat, esophagus, and stomach||Xylocaine Viscous||viscous lidocaine||5 mL|
GI cocktail [7]
A gastrointestinal cocktail, (also known as a GI cocktail or gastric cocktail), is a mixture of medications used to treat symptoms of dyspepsia[1] The GI cocktail generally contains a mixture of viscous lidocaine, an antacid, and an anticholinergic.[1][2] The GI cocktail is commonly prescribed in the hospital or emergency department, and has been used to help distinguish chest pain as either gastrointestinal or cardiac.[1] While it has been widely used in the treatment of dyspepsia, studies have suggested that the GI cocktail is only as effective as antacids alone.[1]. The “GI cocktail” does not refer to a specific product
Anticholinergics work to ease symptoms that accompany dyspepsia including nausea, vomiting, and abdominal cramping.. The GI cocktail is a mixture of a viscous anesthetic, an antacid, and an anticholinergic.[1][2] Common viscous anesthetics use are viscous lidocaine or xylocaine
The GI cocktail is commonly prescribed in the hospital or emergency department to treat symptoms of dyspepsia.[4] These symptoms include: belching, heartburn, chest pain, abdominal discomfort, abdominal bloating, nausea, loss of appetite, and flatulence. Dyspepsia itself is not an illness, rather it is an indicator of chronic underlying gastrointestinal issues such as peptic ulcer disease, gastro-esophageal reflux disease, h.pylori gastritis, gastroparesis, or upper gastrointestinal cancers.[5][6] Dyspepsia can additionally be contributed to medications such as potassium supplements, NSAIDs, digitalis, iron, glucocorticoids, and colchicine, as well as lifestyle factors such as diet, stress, and cigarette smoking.[5][6]
GI Cocktail: Indigestion Fix or Antacid Hoax? [8]
Digestive Health Heartburn Treatment Do GI Cocktails Really Work? By Brittany Poulson, MDA, RDN, CD, CDCES Brittany Poulson, MDA, RDN, CD, CDCES Verywell Health’s LinkedIn Brittany Poulson, MDA, RDN, CDCES, is a registered dietitian and certified diabetes care and education specialist. Learn about our editorial process Published on September 27, 2021 Medically reviewed by Jay N
Learn about our Medical Expert Board Print Table of Contents View All Table of Contents Ingredients Symptoms Possible Benefits Possible Disadvantages Indigestion Relief Frequently Asked Questions A gastrointestinal (GI) cocktail, also known as a gastric cocktail, is a combination of different medicines you can drink aimed at relieving digestive upset and chest pain. What exactly is in a gastric cocktail can vary, and its effectiveness is highly debated
Verywell / Laura Porter GI Cocktail Ingredients GI cocktails are not a single product. Rather, as the name cocktail implies, it is a combination of several medications
GI Cocktail Ingredients [9]
A GI cocktail, also known as a gastrointestinal cocktail, is a combination of medications given to patients in the emergency department of hospitals. It’s often given to patients complaining of indigestion, which is frequently the result of a condition like acid reflux, ulcers, and gastritis.
The three ingredients found in a GI cocktail include a liquid antacid, an anesthetic (usually viscous lidocaine), and an anticholinergic.. Are you wondering how effective a GI cocktail is, or do you need more information about its ingredients? Well, you’ve come to the right place! Read on to learn everything you need to know about GI cocktails!
Those ingredients are an anesthetic, which is typically viscous lidocaine, an anticholinergic, and a liquid antacid. The combination of these ingredients should help relieve symptoms of gastrointestinal distress caused by acid reflux, ulcers, and gastritis.
Gastric Cocktail for Pain Management [10]
What exactly is in it? I have been on prevacid for many years now, I have tried nexium and some other meds and they don’t seem to work anymore. My old gastro kind of tuned me out when I told him I was dx’d with fibromyalgia and possibly lupus
So I had my first appt with the new gastro, but they won’t do a colonoscopy until I get the ok by the pulmonary doc for it. I had an endoscope by the old gastro doc and he said he saw esophagitis, but said he didn’t need to see me again
I tried malox too and that doesn’t give me any relief.. I saw the post about the cocktail and am wondering if I need to ask my doc about this
Don’t use lidocaine for epigastric pain [11]
I have previously covered a paper from 2003 that showed that the “pink lady” or “GI cocktail” provides no benefit to patients, but lidocaine is still widely used for epigastric pain in emergency medicine. Of course, that prior paper was somewhat messy, as it included an anticholinergic in the GI cocktail, so maybe people were just waiting for a cleaner RCT to change their practice
Antacid monotherapy is more effective in relieving epigastric pain than in combination with lidocaine. doi:10.1111/acem.14069 PMID: 32602148 Australian New Zealand Clinical Trials Registry ACTRN12619000928112
10 mL of antacid (Gastrogel: 500mg AlOH, MgSO3 240mg, MgOH24mg per 500ml) plus 10 mL of lidocaine 2% solution (the same 2% lidocaine you use for injection).. 10 mL of antacid plus 10 mL of lidocaine 2% viscous gel.
Chest Pain Malpractice Claims & “Bedside Maneuvers” [12]
Malpractice claims related to the chief complaint of chest pain continue to plague clinicians. Foremost among these claims is the allegation of “missed MI,” which has now been expanded to include missed unstable angina as well as missed actual myocardial infarction.
A 47-year-old man enters an emergency department with chest pain and is given a mixture of liquid antacid, viscous lidocaine, and an antispasmodic; he was discharged “feeling better.” He collapses in cardiac arrest at home and dies. During the malpractice trial, expert witnesses were critical of the emergency physician for not performing an ECG, for not obtaining cardiac enzymes, and for allowing the results of the GI cocktail to “guide his decision-making.” The jury awarded $1 million to the surviving spouse in a verdict against the ED physician.
James Herrick first described the syndrome of coronary thrombosis, thousands of people who died while vomiting and clutching their chests had their cause of death listed as “acute indigestion.” Nobody dies of indigestion; these were all acute coronary syndromes!. – There is considerable overlap in the symptoms produced by gastrointestinal and coronary diseases
An unfortunate twist [13]
FR was a 55-year-old woman who developed relatively acute and diffuse upper abdominal pain shortly after finishing dinner with friends at a local restaurant. Over the next 1-2 hours and after returning home, FR’s pain became most severe and was associated with nausea and emesis
On arrival at the ED, FR had a normal blood pressure and heart rate, but complained of 10/10 abdominal pain. On examination, FR was noted by the ED physician as “uncooperative answering questions, rocking in bed moaning.” The abdomen was documented as soft but diffusely tender to palpation in all four quadrants
The initial impression by the ED physician was biliary colic, and he also ordered a right upper quadrant ultrasound. In the meantime, FR received a “GI cocktail” (Mylanta, viscous lidocaine, and Donnatal) by mouth, along with intravenous morphine and Zofran
And Thus Ends the GI Cocktail [14]
Antacid monotherapy is as effective, if not more effective, than GI cocktails with lidocaine, is more palatable, and has fewer side effects.. In prior studies, it is questionable whether additives like lidocaine or donnatal are…well additive to effectiveness beyond a simple antacid.
For the primary outcome of pain reduction on visual analog scale (VAS) at 30 minutes, both antacid and antacid+solution gave clinically significant pain reduction. VAS reduction in pain was 20 (antacid), 17 (antacid+solution), and 9 (antacid+viscous)
There was no statistical difference between the three groups. Antacid alone was (non-significantly) more effective than all the others
Antacid Monotherapy vs GI Cocktail: Are You On or Off the Wagon? – St. Joseph’s Health Center: Emergency Medicine Residency Blog [15]
Antacid Monotherapy vs GI Cocktail: Are You On or Off the Wagon?. Background: Dyspepsia and epigastric pain are common emergency department (ED) complaints affecting one in four adults annually
Antacids are often a first-line treatment in relieving the discomfort of dyspepsia and epigastric pain (Salisbury 2021). Antacids can be paired with other medications to create the “GI cocktail.” The combination often includes a mixture of antacid, viscous lidocaine, and anticholinergic medication
The efficacy of one approach over another, giving an antacid with or without lidocaine or other medications, is unknown.. Antacid Monotherapy Is More Effective in Relieving Epigastric Pain Than in Combination With Lidocaine: A Randomized Double-blind Clinical Trial
Episode 553: Will this finally be the end of the “GI Cocktail”? [16]
In this episode, I’ll discuss a study of the treatment of dyspepsia in patients who present to the emergency department.. The use of a “GI Cocktail” with varying ingredients is popular in emergency departments both to treat dyspepsia and to attempt to distinguish nonischemic from ischemic chest pain.
GI Cocktails have traditionally contained a mixture of Donnatal, antacid, and viscous lidocaine. When Donnatal liquid became unavailable, the mixture was continued with antacid and viscous lidocaine.
This is because a patient with ischemic chest pain can present with dyspepsia that resolves with a GI cocktail. However the use of antacid plus viscous lidocaine continues for the treatment of dyspepsia in the ED.
Do Antacid Monotherapy or GI Cocktails Work Better for Epigastric Pain? [17]
A 43-year-old woman arrives at the emergency department complaining of epigastric pain after eating a large lunch. She has presented to the emergency department a few times before for a similar presentation and been diagnosed with gastroesophageal reflux disease (GERD)
She says it works but tastes awful and asks if there is anything else she could try this time.. Explore This IssueACEP Now: Vol 39 – No 11 – November 2020
Antacid, either alone or combined with other medications, is routinely given to ED patients suffering with epigastric pain. Such medications include viscous lidocaine, an antihistamine, a proton pump inhibitor, or an anticholinergic.1,2 In the United States, the combination treatment has been referred to as a “GI cocktail,” while in Canada and Australia it is commonly called a “pink lady.”
What Is a GI Cocktail? [18]
A GI cocktail, sometimes known as “green lizard” or “green goddess” is used to treat dyspepsia.. A GI cocktail or gastrointestinal cocktail is a mixture of liquid antacid, viscous lidocaine, and an anticholinergic agent
There are a wide variety of GI cocktail recipes nowadays. One popular recipe is a mixture of viscous lidocaine, Maalox, and Donnatal in a mixture of 10-30 ml Mylanta, 10 ml viscous lidocaine, and 10 ml of Donnatal
Due to the varied mechanisms of relief, the efficacy of this mixture is considered far more superior than taking only one of its components. However, according to a recent study, it has been found that an antacid alone can relieve stomach pain when compared to a GI cocktail.
Cost increase spurs review of “GI cocktail” components, effectiveness [19]
Kate Traynor, Cost increase spurs review of “GI cocktail” components, effectiveness, American Journal of Health-System Pharmacy, Volume 73, Issue 6, 15 March 2016, Pages 355–356, https://doi.org/10.2146/news160019. At Marion General Hospital in Indiana, an increase in the cost of one component of the facility’s gastrointestinal (GI) “cocktail” prompted a review of the usefulness of that medication and an evidence-based change to the compounded admixture.
Donnatal contains phenobarbital, hyoscyamine sulfate, atropine sulfate, and scopolamine hydrobromide. The product is marketed by Concordia Pharmaceuticals Inc., a West Indies–based subsidiary of Concordia Healthcare Corp
Greene said that after a noticeable increase in the price of Donnatal, she looked for scientific literature about the effectiveness of GI cocktails. “A couple of articles … seemed to imply that there was not a lot of benefit beyond the antacid,” Greene said.
Sources
- https://www.timeofcare.com/gastrointestinal-cocktail-gi-cocktail/#:~:text=GI%20Cocktail%20or%20Gastric%20Cocktail,patient%20for%20about%2015%20minutes.
- https://www.webmd.com/digestive-disorders/what-to-know-gi-cocktails#:~:text=The%20viscous%20lidocaine%20works%20as,other%20symptoms%20of%20gastrointestinal%20conditions.
- https://en.wikipedia.org/wiki/GI_cocktail#:~:text=The%20%22GI%20cocktail%22%20does%20not,work%20to%20neutralize%20stomach%20acid.
- https://ward3.com/how-long-does-a-g-i-cocktail-last/
- https://www.webmd.com/digestive-disorders/what-to-know-gi-cocktails
- https://www.healthline.com/health/gi-cocktail
- https://en.wikipedia.org/wiki/GI_cocktail
- https://www.verywellhealth.com/gi-cocktail-ingredients-5201921
- https://www.upthirst.com/gi-cocktail-ingredients-with-benadryl/
- https://www.healingwell.com/community/default.aspx?f=45&m=643430
- https://first10em.com/dont-use-lidocaine-for-epigastric-pain/
- https://blog.thesullivangroup.com/rsqsolutions/chest-pain-malpractice-claims
- https://www.mdedge.com/gihepnews/article/84491/practice-management/unfortunate-twist
- https://journalfeed.org/article-a-day/2020/and-thus-ends-the-gi-cocktail/
- http://stjoesemresidency.com/antacid-monotherapy-vs-gi-cocktail-are-you-on-or-off-the-wagon/
- https://www.pharmacyjoe.com/will-this-finally-be-the-end-of-the-gi-cocktail/
- https://www.acepnow.com/article/do-antacid-monotherapy-or-gi-cocktails-work-better-for-epigastric-pain/
- https://www.findatopdoc.com/Healthy-Living/GI-cocktail
- https://academic.oup.com/ajhp/article-abstract/73/6/355/5101749
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