Reading...
Play button
Play button
Use LEFT and RIGHT arrow keys to navigate between flashcards;
Use UP and DOWN arrow keys to flip the card;
H to show hint;
A reads text to speech;
9 Cards in this Set
- Front
- Back
|
H pylori / PUD treatment
|
Only tx c documented +
1. PPI/H2 blocker x 7-14 d 2. Clarithromycin x 7-14d 3. Amox x 7-14d 4. Antacids prn |
|
|
H2 blockers
|
Used in PUD/GERD
-"dine" drugs (cimetidine, famotidine, ranitidine, nizatindine). -inhibit histamine binding to H2 receptors - decrease acid secretion -QD-BID dosing -relief w/in 2 wks |
|
|
Proton pump inhibitors
|
-PUD/GERD tx
-"zole" (esomeprazole, lansoprazole, omeprazole, pantoprazole, rabeprazole) -decrease acid secretion almost completely leading to fast relief -faster ulcer healing than c H2 blockers. -can use for years |
|
|
Stepwise GERD tx
|
1. Mild s/s: lifestyle changes
2. Decrease acid production: antacids + H2 blockers OR PPIs 3. Promotility therapy for delayed gastric emptying/persistent s/s: metoclopramide (Reglan), bethanechol (Urecholine) - many SE's to these drugs. 4. Antireflux surgery: nissen fundoplication, endoscopic suturing - 30-40% still need to use PPI |
|
|
substances/conditions that decrease LES tone (GERD)
|
Chol/fat, chocolate, spicy, acidic food, peppermint, caffeine, tobacco, etoh.
tight clothes, obesity, ascities, preg, CNS dz, hiatal hernia, DM, others |
|
|
Meds that decrease LES tone
|
1. Smooth muscle relaxants (theophyline, nitrates, CCB's -verapamil/nifedipine).
2. progesterone 3. nicoteine-transdermal 4. diazepam 5. meperidine 6. anticholinergics-atropine, scopalamine, belladonna |
|
|
Meds to avoid in GERD
|
Meds that can injure esophageal mucosa: tetracyclines, quinidine, wax-matrix KCl tablets, nsaids
|
|
|
Oral Rehydration Therapy
|
-For mild/mod dehydration
-Resume feeding after rehydration complete -Infants: <2yr rapid rehydration in 4-6hr followed by diluted forumla/milk -Kids>2yr: rice cereal, bananas, potatoes, yogurt, lean meats -adult: complex cho's, lean meat, yogurt, fruit, veg -added fluids after each stool: <2yr-50-100cc, 2-10yr-100-200cc, >10yr ad lib. -ORT: Hydra-Lyte, Rehydralyte, Pedialyte, Infalyte, Ricelyte, etc. |
|
|
Risk factors for cholelithiasis
|
A: age (old)
B: body habitus (obese, rapid wt loss) C: childbearing (preg) D: drugs (fibrates, OCPs, estrog/progesterones E: ethnicity (Pima Indian, scandinavian) F: family hx (maternal hx stones) G: gender (female) H: hyperalimentation (TPN, fasting) I: ileal/metabolic (Crohn's, DM, etoh cirrhosis, high triglycerides) |
