Term
meds that exacerbate GERD
(decrease LES tone) |
|
Definition
anticholinergics
dihydropyridine CCB
barbiturates
estrogen and progesterone
opioids
theophylline
|
|
|
Term
|
Definition
asa
iron
nsaids
kcl
bisphosphonates |
|
|
Term
|
Definition
diet
alcohol
fat
peppermint
tomato based products
chocolate
caffeine
(basically everything i love) |
|
|
Term
| other precipitating causes |
|
Definition
smoking
preggers
running
tight clothes
lifting
obesity |
|
|
Term
|
Definition
heartburn/retrosternal pain
acid or food regurgitation
dyspepsia or belching |
|
|
Term
|
Definition
pulmonary - aspirate, hoarseness, dry cough
dental erosions
hoarseness
chest pain |
|
|
Term
|
Definition
GI bleed
early satiety
dysphagia or odynophagi
unexplained wieght loss
iron deficiency anemia
vomiting
|
|
|
Term
|
Definition
relieve sx
heal esophagiitis
avoid complications
treat in cost effective manner |
|
|
Term
|
Definition
1. lifestyle mod
2. pharm
3. surgery |
|
|
Term
| 1st - lifestyle modifications (23% response rate) |
|
Definition
continue throughout the tx of GERD
smaller, more frequent meals
avoid eating close to bedtime
elevate bed 6-8"
avoid food that lower LES tone: choc, fat, pepp, caffeine, acidic juic
lose weight
reduce or eliminate alcohol and smoking |
|
|
Term
|
Definition
neutralize stomach acid
drug interactions: tetras, quinolones, levothyroxine, isoniasid, sulfonureas
|
|
|
Term
|
Definition
diarrhea
ca and aluminum = constipation |
|
|
Term
| what stimulates hcl production in stomach? |
|
Definition
| histamine, ach and gastrin |
|
|
Term
| t/f: tachyphylaxis often develops with H2RAs? |
|
Definition
|
|
Term
|
Definition
| WARFARIN, alcohol, phenytoin, and theophylline |
|
|
Term
| What is the biggest AE with h2ra's? |
|
Definition
HEADACHE
dizziness
constipation/dia
somnolence |
|
|
Term
cimetidine (TAGAMENT)
OTC/rx dose
IV? |
|
Definition
100mg bid/ 400 mg qid or 800 mg bid
yes, IV available |
|
|
Term
famotidine (PEPCID)
OTC/RX DOSE
IV? |
|
Definition
10 MG BID / 20-40 MG BID
YES |
|
|
Term
nizatidine (AXID)
OTC/RX
IV |
|
Definition
75 MG BID / 150 MG BID
NO
|
|
|
Term
rantidine (ZANTAC)
OTC/RX
IV
|
|
Definition
75 mg / 150-300 MG BID
YES |
|
|
Term
|
Definition
decrease gastirc acid secretion via irreversibly inhibiting the H/K ATPase..but only active pumps
|
|
|
Term
| What is the DOC for healing esophagitis for severe disease? |
|
Definition
|
|
Term
| With PPIs, what is the patient education pearl? |
|
Definition
take 30 min before meal
need med on board to stop the pumps stimulated by food...confusing since they are dosed continuously |
|
|
Term
| long term effects of PPIs |
|
Definition
increased risk of fractures
gastroenteritis
double risk of cdiff |
|
|
Term
|
Definition
atazanavir
itraconazole
iron
clopidogrel
thank you, clinical skills |
|
|
Term
Which PPIs are not available IV?
|
|
Definition
omeprazole (prilosec)
rabeprazole (aciphex) |
|
|
Term
|
Definition
metoclopramide(4x dosing and CNS effects)
cisapride (QT prolongation)
domperiodone (serious FDA issues) |
|
|
Term
| What are the interventional therapies? |
|
Definition
nissen funoplication (wrap stomach around)
endoscopic sewing device (endocinch)
stretta device |
|
|
Term
Esomeprazole (nexium)
OTC dose/ EE |
|
Definition
| 40 mg daily/ 20-40 mg daily 4-8 weeks |
|
|
Term
|
Definition
| 15 mg/ 30 mg daily 8-16 weeks |
|
|
Term
|
Definition
| 20 mg/ 20 mg daily 4-8 weeks |
|
|
Term
|
Definition
| 40 mg / 40 mg daily, 8 weeks |
|
|
Term
|
Definition
| 20 mg/ 20 mg daily 4-8 weeks |
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