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62 Cards in this Set
- Front
- Back
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GERD symptoms that require physician intervention
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Difficulty swallowing
Coughing Regurgitation of food |
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Etiology: PUD
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Gastric/duodenal ulcer
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GERD: Typical symptoms
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Heartburn
Acid regurgitation (acid taste in mouth) Hypersalivation |
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Dyspepsia: Typical symptoms
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Primary: Epigastric discomfort
Secondary: Belching or burping Bloating Nausea Early satiety May be accompanied by heartburn & acid regurgitation |
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PUD: Typical symptoms
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Gnawing or burning epigastric pain, occurring during day and frequently at night
May be accompanied by heartburn and dyspepsia |
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GERD: Complications
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Erosive esophagitis
Strictures Barrett's espohagus Esophageal cancer |
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PUD: Complications
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Perforation
Obstruction Penetration Bleeding |
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GERD: Alarm symptoms
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Dysphagia
Odynophagia Chest pain Upper GI bleeding Unexplained weight loss Continuous nausea, vomiting, & diarrhea |
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PUD: Alarm symptoms
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Upper GI bleeding
Unexplained weight loss Continuous nausea, vomiting, & diarrhea |
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GERD: Atypical symptoms
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Asthma
Chronic laryngitis Hoarseness Cough Globus sensation (lump in throat) Noncardiac chest pain Dental erosions |
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Heartburn risk factors: Dietary
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Fatty foods
Spicy foods Chocolate Table salt Garlic / onions Mint Alcohol Caffeinated beverages Carbonated beverages Citrus fruit or juices Tomatoes / juice |
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Heartburn risk factors: Lifestyle
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Exercise
Smoking Obesity Stress Supine body position Tight clothes Pregnancy |
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Heartburn risk factors: Diseases
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Motility disorders (e.g., gastroparesis)
Scleroderma PUD Zollinger-Ellison Syndrome |
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Heartburn risk factors: Medications
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Bisphosphonates
Aspirin / NSAIDS Iron Potassium Quinidine Tetracycline Zidovudine Anticholinergic agents Alpha-adrenergic agonists Barbiturates Beta-2-adrenergic agonists Calcium channel blockers Benzodiazepines Dopamine Estrogen Narcotic analgesics Nitrates Progesterone Prostaglandins Theophylline TCAs Chemotherapy |
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Heartburn risk factors: Other
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Genetics
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Antacids (ingredients)
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Magnesium
Aluminum Calcium Sodium bicarbonate Magaldrate |
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Antacids: Consequences of use
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Constipation
Diarrhea Gas / bloating |
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Antacids: At-risk populations
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Impaired renal functions
Persons on drugs that are influenced by pH |
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Antacid drug interactions: Chelation
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Tetracyclines
Quinolones |
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Antacid drug interactions: Drugs that need low pH for absorption
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Itraconazole
Iron Ketoconazole |
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Alka-Seltzer
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Sodium bicarbonate
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Magnesium/aluminum combinations
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Maalox
Mylanta |
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Calcium/magnesium combination
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Rolaids
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Nizatidine
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Axid AR
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Cimetidine
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Tagamet HB
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Ranitidine
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Zantac 75
Zantac 150 |
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Cimetidine: Max daily dose
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400 mg
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Cimetidine: Usual dose
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200 mg
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Nizatidine: Usual dose
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75 mg
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Nizatidine: Max daily dose
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150 mg
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H2 antihistamines: Instructions for taking
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Take 1 tablet w/ a large glass of water
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Pepcid AC: Strength
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Famotidine 10 mg
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Pepcid AC Maximum Strength: Strength
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Famotidine 20 mg
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Famotidine: Max daily dose
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2 tablets or 40 mg
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Ranitidine: Usual dose
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75 or 150 mg
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Ranitidine: Max daily dose
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2 tablets or 300 mg
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Pepcid Complete
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Famotidine 10 mg
Calcium carbonate 800 mg Magnesium hydroxide 165 mg |
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Pepcid Complete: Instructions
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Chew & swallow 1 tablet
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Pepcid Complete: Max daily dosage
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2 tablets
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Omeprazole: Instructions
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1 tablet with a glass of water 30 minutes before morning meal
Do not chew or crush tablets Take daily for 14 days |
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H2 Receptor Antagonists: Consequences of use
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Rare:
Diarrhea Constipation Headache |
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H2 Receptor Antagonists: At-risk populations
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Elderly patients
Impaired renal & hepatic function (may require dosage reduction; see physician) |
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Cimetidine: Binding
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Binds to CYP3A4, 2D6, 1A2, 2C9
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Cimetidine: Inhibits metabolism of...
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Phenytoin
Warfarin Theophylline TCAs Amiodarone |
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Omeprazole: MOA
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Irreversibly blocks the final step of gastric acid secretion at the proton pump
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Omeprazole: Time for full effect
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1 to 4 days
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Omeprazole: Consequences of use
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None
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Omeprazole: Drug interactions
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Drugs where gastric pH is an important determinant of bioavailability
Ketoconazole Ampicillin Iron salts Digoxin Cyanacobalamin |
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Omeprazole: At-risk populations
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Difficult or painful swallowing
Vomiting blood Bloody or black stools Pregnancy / lactation (seek physician advice) |
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Omeprazole: At-risk populations (symptoms)
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Heartburn > 3 months
Stomach pain Heartburn w/ wheezing, unexplained weight loss, nausea, vomiting Heartburn w/ lightheadedness, dizziness, chest pain, shoulder pain w/ SOB, sweating, or pain spreading to arms, neck, or shoulders |
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Mylicon
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Simethicone
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Phazyme
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Simethicone
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Beano
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Alpha-galactosidase
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Simethicone: MOA
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Reduces surface tension on existing bubbles
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Simethicone: Consequences of use
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Uncommon, GI
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Alpha-galactosidase: Consequences of use
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Rare (none)
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Alpha-galactosidase: At-risk populations
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Diabetics?
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Gas-X
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Simethicone
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Bismuth subsalicyclate: Consequences of use
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Black stool
Black tongue or dental appliances |
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Bismuth subsalicylate: At-risk populations
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Allergy to salicylates
Children Ulcer Abnormal bleeding Bloody or black stool Anticoagulation Gout |
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Antacids that cause constipation
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Aluminum
Calcium |
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Antacids that cause diarrhea
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Magnesium
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