GI and..
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| what is the recommended starting dose for cimetidine (Tagament) | 400 mg QID or 800 mg BID for max of 1600 mg daily
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| what is the recommended starting dose for famotidine? brand? is it avaible OTC and generic | 20 mg bid, brand is PEPCID, AVAILABLE in generic and OTC
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| what is the recommended starting dose for nizatidine? brand? is it available OTC and Generic | 150 mg bid, AXID, yes, yes
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| what is the recommended starting dose for ranitidine, brand, OTC? generic? | 150 mg bid, Zantac, YES, YES
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| what is sucralfate, how does it work, what is the brand? | derivate of sea weed,Carafate, is a nonabsorbable aluminum slaf of sucrose octasulfate that has limited value. It produces a loacl effect, binds to tissue protecting it from acid, pepsin, and bile salts
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| what is metoclopramide, what is the brand, why isn't it used often, what could it be used for | promotility agent-a dopamine antagonist, increase LES pressure in a dose related manner and accelerates gastric emptying. NOT IMPROVE ESPOHAGEAL CLEARANCE. Tachyphylaxis and ADRs limit its usefulness.
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| When would a promotility agent be used and why not used often in GERD? w | promotility agents may be useful as adjuncts to acid suppression therapy in patients with know motility defects ( LES incompetence, decreased esophageal clearance, delayed gastric emptying).Not as effective as acid suppression therapy and >SE
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| When might a drug with Zegerid be used and what should you be concerned with, what is it made of? | it is a combination product containing omeprazole 20 to 40 mg with sodium bicarbonate in immediate release oral capsules and powder for oral suspension. GOOD FOR NASOGASTRIC TUBES. Caution with sodium restriction. Does have a quicker onset of action*
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| How should patients be instructed to take PPI's | in the morning 15 to 30 mins before breakfast to maximize efficacy because these agents inhibit only actively secreting proton pumps.
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| which PPI's have most side effects and interactions | omeprazole and esomeprazole
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| how do PPIs work | by blocking gastric acid secretion by inhibiting hydrogen potassium ATPase in gastric parietal cells, works systemically and not in the stomach before absorbed
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| what are some nonpharmacologic treatments of GERD | elevate bed, drink WATER, use wedge pillow, eat small meals, include protein rish meals to augment lower esophageal sphinter pressure, avoid fats, chocolate, alcohol,spicy, OJ, stop smoking, wear loose cloths, loose weight
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| which foods decrease lower esophageal shinter pressure | fatty meals, carminative (peppermint, spearmint), chocolate, coffee, cola, tea, garlic, onions, chili peppers
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| which medications decrease the lower esophageal sphinter pressure | anticholinergics, barbiturates, caffeine, dihydropyridine, calcium channel blockers, dopamine, estrogen, ethanol, nicotine, smoking, nitrates, progesterone, tetracycline, theophylline
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| which medications cause direct irritation to the esophageal mucosa | aspirin, bisphosphates (alendronate), NSAIDS, IRON, quinidine, potassium chloride
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| which foods are contributed to being direct irritants of esophageal mucoas | spicy foods, orange juice, tomato juice, and coffee
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| which foods are both irriants and decrease lower esophageal sphicter pressure | coffee, spicy food (chili peppers)
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| which drugs are helpful in esophageal clearance | she says nothing really but oked the bethanechol
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| which drugs are helpful in gastric emptying | metoclopramide
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| which drugs are effective in increasing LES pressure | bethanechol and metoclopromide
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| which drugs are effective in decrease gastric acid | antacids, H2 receptor antagonist, and PPIS
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| when should the patients seek medical attention when on OTC selftreatment | if symtoms are unrelieved with lifestyle modifications adn nonprescription medications after 2 weeks
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| how should antacids be dosed, MOA, side effects, common products, interactions and conseling points | provide immediate, symptomatic relief for mild GERD. the increase urinary pH, bind with other drugs. should take two tablets four times daily after meals and at bedtime but cannot be maintained with BT dose. Make sure an space out
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| what is gaviscon and how does it work | an antacid with alginic acid that is not a potent acid neutralizing agent, but does form a viscous solution that floats on the surface of the gastric contents. No longer effective after the patient lays down
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| key couseling points are on GERD therapy are | tell patient not going to work right away, Can use antacids along with PPIs but should be spread out
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| when should maintence therapy be considered to prevent complications and worseing of esophageal function | in patients who have symptomatic relapse after discontinuation of therapy or dosage reduction, including patients with complications such as barrett's esophagus, strictures, or hemorrhage
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| when is on demand therapy effective | patients with endoscopy negative GERD
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| what is the side effects of magnesium | diarrhea
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| what is the side effects of calcium and aluminum | constipation
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| when aluminum and magnesium are combined the outcome is usually | diarrhea
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| what is the recommended dosage of famotidine in a child younger than 3 months old | 0.5 mg/kg/dose daily
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| what is the recommened doseage of famotidine in a child that is greater than 3 months old | 0.5 mg/kg/dose twice daily
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| what is the recommened dosage of ranitidine in a one month old to 16 yo patient | 5-10 mg/kg/day give BID
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| what is the lansoprazole dosage in a child < one year but not approved for this age | < 1 yr 0.5 to 1.6 mg/kg/day. these regimens are only approved for eight weeks
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| what are the common side effects of H2R antagonist | HA, diarrhea, drowsiness, fatigue, muscle pain, constipation, CNS side effects- less common
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| what dosage forms does tagament come in | tablet, solution, injection
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| what are the drug interactions that are found when using cimetidine | theophyline, lidocaine, phenytoin, quinidine, and warfarin
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| what are some drug interactions with nizatidine (axid) | salicylates
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| who has the highest risk of developing any of the adverse effects of H2 receptor antagonist | elderly, those requiring higher doses (usually parenteral), and those with altered renal fxn
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| what are the drug interactions with omeprazole and in who should this drug be cautioned in | slow metabolizer use caution, causes decreased clearance of diazepam, phenytoin, and warfarin, macrolide, and digixin
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| what is the significant drug interaction with Aciphex | Warfarin
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