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103 Cards in this Set
- Front
- Back
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Allopurinol interacts with which antacids
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Aluminum
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Phenytoin interacts with which antacids
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Magnesium
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Cephalosporins interacts with which antacids
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Aluminum
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Oral anticoagulants interacts with which antacids
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Magnesium
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Tetracycline interacts with which antacids
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Aluminum, Magnesium, Calcium carbonate
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Glipizide interacts with which antacids
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Magnesium, Sodium bicarbonate
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Valproic Acid interacts with which antacids
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Aluminum, Magnesium
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Dexamethasone interacts with which antacids
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Magnesium
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Propranolol interacts with which antacids
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Aluminum
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Aspirin interacts with which antacids
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Calcium carbonate
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Atenolol interacts with which antacids
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Aluminum, Calcium carbonate
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Amphetamine interacts with which antacids
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Sodium bicarbonate
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Diazepam interacts with which antacids
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Aluminum
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Prednisone interacts with which antacids
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Aluminum
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Digoxin interacts with which antacids
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Aluminum, Magnesium
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Cimetidine interacts with which antacids
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Aluminum
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Ranitidine interacts with which antacids
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Aluminum
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Indomethacin interacts with which antacids
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Magnesium
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Iron interacts with which antacids
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Aluminum, Magnesium, Calcium carbonate, Sodium bicarbonate
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Quinidine interacts with which antacids
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Magnesium, Calcium carbonate
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Isoniazid interacts with which antacids
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Aluminum, Magnesium
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Ketoconazole interacts with which antacids
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Aluminum, Sodium bicarbonate
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Indomethacin interacts with which antacids
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Aluminum
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Diflunisal interacts with which antacids
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Aluminum
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Sodium polystyrene sulfonate interacts with which antacids
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Magnesium, Calcium carbonate
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Fluoroquinolones interacts with which antacids
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Aluminum, Magnesium
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Age to refer
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12 YO
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Difficulty in treating teen
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hard to get a true story about heartburn/dyspepsia/stress
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Treat HB in preg?
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Could always refer, or treat with antacids only and not in 2nd or 3rd
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Age to treat ped
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12 with antacids, 18 with ppi
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Prob treating >50 YO for HB
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take more medications. Antacids interact with everything.
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How many weeks can we treat OTC
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Two. Antacid recommendation should work same day, if not move on.
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HB non-pharm therapy part I
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Elevate bed, eat 3 hrs before bed or more, avoid food that reduce LES tone (choc, mints, fats), avoid direct irritants (coffee, citrus), smaller meals
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HB nonpharm therapy part II
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Don't lay down, limit alcohol, sot smpking, stop things that introduce air (gum, soda)
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Treament time
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2 Weeks max.
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If treatment works then symptoms recur after 2 weeks when you stop
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refer
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Odynophagia -
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painful swallowing
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Why only treat HB for 14 days
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GERD can lead to other problems: esoph ulcers/strictures; cancer; bleeds, barrett's esoph
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Atypical symptoms of GERD
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Wheezing, teeth erosion, laryngitis, chest pain, chronic cough
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Antacids don't
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change the amount of acid that is there, but neutralize it.
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H2's do what
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Block histamine receptor - block a piece of the acid pump
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PPI's do what
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Blocks the acid pump
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Four compounds for antacids
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NaBicarb, CaCarbonate, Mg Salts, Al Salts
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Antacids have a lot of
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drug interactions.
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Antacids taste
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Chalky
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Makes liquid antacid taste better
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Refrigerating
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How long does antacid last?
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NaHCO3 & MgOH<AL-Mg<AlOH & CaCO3
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Renal impaired antacid?
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Probably steer away.
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Mg antacid SE
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treats constipation, causes diarrhea
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Al SE
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causes constipation
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Combo of Mg & Al SE
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net no effect of diarrhea/constipation hopefully, but diarrhea if one prevails.
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CaCO3 antacid prob
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Too much Calcium may cause acid rebound
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NAHCO3 prob
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Potent, can cause acid rebound, Na overload
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Alginic acid
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if have reflux, the foam will hit the esophag and not the stomach acid. In Gaviscon
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Simethicone is for
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Intestinal gas
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Orlistat non approved
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Non-obese
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Dosing of orlistat
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60 mg BID
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Heartburn is:
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Burning sensation in the lower chest (substernal)
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Heartburn pain is where
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May radiate up in the the chest, back, maybe throat or neck
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HB occurs when
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After meals, lying down, bending over, after exercise
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Symptoms of HB
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Dysphagia, odynophagiea, globus sensation, hypersalivation, weight loss, regurg w/o nausea, acid/"sour" stomach
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Dyspepsia
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Consistent or recurrent pain in upper abdomen, subjective, get full when eatin,
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HB/dyspep treatment goals
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Relieve, prevent, heal esoph, prevent GERD
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Factors for HB
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Diet, lifestyle, obesity stress,
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Durgs affect HB
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NSAIDs and much more
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When to refer?
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Occurs 2+ times/week; severe, chest pain, 3 months, take NSAIDs, GI bleed
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Why HB commin in preg?
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Space is smushed
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HTN drugs cause HB
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CCB, B2 agonists?; nitrate? Alpha agonists
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HB Alarm Sx
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Hoarseness, CF, weight loss, vomiting, signs of GI bleed, chest pain, chronic NSAID, sx disrupt sleep, any systemic illness
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H2 takes how long to work
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Work within a day
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GERD is
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Abnormal reflus of gastric contents into the esoph, causing mucosal damage
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Epidemiology of GERD
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'50% of US experience Sx; 7-10% have daily HB; 30-50% have Sx monthly
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GERD path
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Impaired acid neut, inappropriate relax of LES, hiatal hernia, delayed gastric emptying
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Antacids for
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HB, sour stomach, acid indigestion, overindulgence, upset stomach "with Sx"
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Acid indigestion unique from HB
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Burping
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Antacids most appropriate for
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Mild, infrequent HB
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Dosing antacids
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mEq of acid neut capacity, not by volume or # of tabs
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Fewest SE of antacids
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Al-Mg combos
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Dosing frequency of antacids
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4-5 x/day
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3 maalox TC =
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9 reg maalox
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Older, 65+ Antacid thoughts
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Watch Na; SE more likely (dia/constip); D-D; Magnesium best if no renal prob
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Preg/lact antactid consid
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Don't use chronically, Avoid NA, Al/Mg/Ca okay
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Drug manufacturers expect oral drugs to what?
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Hit an acidic stomach, so have drug cleared or antacid cleared - not together
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Pure aluminum salts
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Alternagel, constipation is SE
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Calcium carbonate
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TUMS, some rolaids, some Maalox. Most chewables are this.
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Children's Pepto is what
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Calcium carbonate, no bismuth, really tasty
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Al/Mg combo products
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Several Maalox
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Cause of primary dysmen
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Idio, only during ovu cycle
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Cause of secondary dysmen
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Assoc with pelvic paht
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Dysmenorrhea
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Define here
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Primary dysmen responds usually to drug?
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NSAID
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Treatement goals for dysmenorrhea
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Pain relief/symptom improvement, resume daily activities
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Important distinction in dysmenorrhea recommendation
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Distinguish between primary and secondary
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Self treatment of primary dysmen when?
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Self treatment of secondary dysmen when?
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Nonpharm treatment of dysmenorrhea
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Topical heat, omega 3s, DC smoking
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Pharm treatment of dysmenorrhea
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OC, NSAID (Rx dosing) effective for 80-90% of patients, then ASA or APAP
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PMDD
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Premenstrual Dysphoric Disorder, generally a severe form of PMS
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Strassels mnemonic
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This case
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Primary, NSAID
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PT Considerations with APAP
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Safe in preg/lact; low incidence SE; no platelet; counsel on high doses and alcohol use.
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Non-drug treatment for tension headache
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Relaxation/physical therapy
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Non-drug treatment for migrain headache
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Regular sleeping and eating, nutritional strategies.
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