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5 Cards in this Set
- Front
- Back
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What class of antiretroviral medications interact with PPIs?
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Antiretroviral (ARV) medications, particularly protease inhibitors (PIs), are frequently associated with GI upset, including GERD. PPI use may interfere with the antiretroviral activity of PIs, though not other HIV anti-retrovirals, and therefore their co-administration should be avoided and patients should be appropriately counseled to avoid OTC use of these medications as well.
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When is GERD more likely to occur (3)?
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(1) Gastric volume is increased
(2) Gastric contents are nearer LES (3) When gastric pressure is increased |
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Causes of GERD
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(1) Idiopathic
(2) Secondary Causes: - Ascites - Eosinophilic Esophagitis - Esophagitis - Obesity - Pregnancy - Scleroderma - Surgical destruction of the LES - Tobacco use (3) Medications: - Anticholinergics - Benzodiazepines - B-blockers - CCBs - Nitrates - Prostaglandins - Sildenafil - TCAs (4) Foods: - Alcohol - Chocolate - High fat foods - Organges or orange juice - Peppermint/Spearmint - Tomato products |
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If a patient presents with typical heartburn that responds to over-the-counter antacid therapy, what is the next step?
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It is acceptable to treat empirically without further diagnostic workup.
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Indications for GI referral in patients with GERD
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- Any GIB
- Dysphagia - Weight loss - Loss of appetite - Failure to respond to 4-8 weeks of PPIs - Duration of GERD >5 years |
