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18 Cards in this Set
- Front
- Back
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agents used for GERD
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antacids: adj for sx's
H2RA: longer duration but shorter onset. for mild, infrequent sx's PPI: promotes healing (use H2RA first) |
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antacids in GERD
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rapid neutralization but short DOA; doesnt promote healing
*used as adj for sx relief *renal caution: Mg and Al |
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antacid DDI
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TCN
quinolones (cipro, levaquin) ketoconazole (requires acidic enviornment) |
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OTC PPI
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omeprazole (prilosec OTC 20mg)
(rx: 20, 40, max:80) indication: frequent (take a few days to work) heartburn occurring >2x/week dose: 20mg DR QD x14days *do not repeat for 4 mo's |
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H2RA in GERD
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all have OTC dosage but lower and may not promote healing of esophagitis vs rx
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cimetidine and GERD
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tagamet HS 100mg
(rx: 200-800mg) ADR: androgenic (gynecomastia), impotence, DDI |
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famotidine and GERD
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pepcid AC 10mg tab
(rx: 20,40mg) |
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nizatidine
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axid AR 75mg cap
(rx: 150, 300mg cap) no IV |
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ranitidine
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zantac 75mg tab
(rx: 150, 300mg tab) ADR: hematologic (thrombocytopenia w/IV) |
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PPI indications
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all 5 approved for healing and maintenance of erosive esophagitis
*only omeprazole, lansoprazole, esomeprazole for symptomatic GERD "LOE" |
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PPI dosages for GERD
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omeprazole: 20
lasoprazole: 30 rabeprazole: 20 (not FDA) pantoprazole: 40 (not FDA) esomeprazole: 20 |
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PPI w/warfarin DDIs
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ROE w/warfain
rabeprazole (aciphex) omeprazole (prilosec) esomeprazole (nexium) |
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PPI and sx GERD indication
PPI and warfarin DDI |
LOE for GERD
ROE w/warfarin |
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zegerid
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omeprazole + sodium bicarb
IR that doesnt require EC FDA: DU, GU, GERD forms: cap, chew, powder dose: 20-40mg qday for 4-8weeks take 30min before meals |
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when to take PPI
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30 min before meals
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metoclopramine and GERD
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reglan is prokinetic
promotes clearing of acid from esophagus dose: take 30min before sx's up to QID ADR: EPS |
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gaviscon
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alginic acid + AlOH + MgOH
*alginic acid reacts w/Nabicarb in stomach to form barrier *ineffective in supine position (dont take HS) |
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antacids list
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1. MgOH (MOM)
2. AlOH (amphojel, alternagel) 3. Al carbonate (basaljel) 4. MgOH + AlOH (maalox) 5. magaldrate (riopan) 6. Ca carbonate (tums, titralac) |
