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HB & Intestinal Gas

Heart Burn and Intestinal Gas

What is heart burn? substernal burning sensation that moves up toward the neck or throat
What is dyspepsia? consistant or recurrent discomfort located primarily in upper abdomen. epigastric pain, burning, postprandial fullness, nausea, bloating
What is GERD reflux of gastric contents into the esophagus, causing troublesome(more than once a week) symptoms or esophageal damage that interferes with quality of life
What is PUD? gastric or duodenal ulcer caused by an infection or NSAIDS
What are some symptoms of GERD heartburn plus acid regurgitation(acid taste in the mouth), hypersalvation, maybe dyspepsia
What is dysphagia? difficult swallowing
what is odynophagia painful swallowing
Non pharm treatment for HB and dyspepsia (8 things) keep a symptom diary, avoid foods with lower LES pressure, Elevate head of bed by 6in or form a gerd wedge pillow, avoid laying down after meals, lose weight, smaller portions, eat smaller meals, limit NSAID use
Pharm treatment for HB and dyspepsia (4 kinds) antacids, bismuth salycilate, H2RA, PPI
Antacids: whats the max dose/day 600mEq/day
Antacids: how long can you take them? 2 weeks max
Antacids: onset/duration O:max of 5minutes. D: 20-30minutes
Antacids: which are preferred? al-hydroxide and Ca-carbonate
Sodium bicarbonare: whats the brand name alka seltzer
What does sodium bicarbonate provide relief for? short term relief for overeating and indigestion
in which patients should you avoid this drug? CHF, CRF, cirrhosis, edema, sodium restricted diets
Calcium based antacids: what is the brand name for this drug? Rolaids, TUMS
Calcium based antacids: what are some adverse effects? hypercalcemia, milk-alkali syndrome, constipation, benign acid rebound after meals
Calcium based antacids: are these safer in renal patients? yes but in smaller doses, still be cautious in CRF patients
Calcium based antacids: is this ok in pregnant patients, elderly as a calcium supplement? yes!
Aluminum based antacids: what is the brand name for this drug? mylanta maximum strength, maalox
Aluminum based antacids: who should caution using this product? CRF
Aluminum based antacids: What are some side effects? consipation, hyperphosphateemia and intestinal obstruction
Magnesium based antacids: what are hte brand names for this drug? mylanta ultimate strength, milk of magnesia
Magnesium based antacids: who should caution using this product CRF
Magnesium based antacids: what are some side effects diarrhea, cardiac arrythmias, respiratory depression, hypotension, NV, muscle paralysis
Magnesium based antacids: how can you decrease side effects of this drug? use in combination with aluminum products
Alginic acid: what is the brand name of this drug gaviscon
Alginic acid: whats the MOA forms a barrier that floats on top of the liquids in the stomach
Alginic acid: when can this be used? GERD not PUD
Bismuth Subsalycilate: what is the brand name for this drug kaopectate, peptobismol
Bismuth Subsalycilate: when should you use this HB, upset stomach, indegestion, nausea and diarhhea
Bismuth Subsalycilate: what are some side effects? darkened stool and tongue
Bismuth Subsalycilate: dosing 2 chewable tabs or 2 TBS after meals for no more than 14 days
H2RA: what are hte brand names for this drug pepcid, zantac, tagamet, axid AR
H2RA: When should this be used? treatment of mild to moderate, infrequent, episodic HB and for the prevention of HB associated with acid indegestion
H2RA: onset and duration O: 30-45 min D: 4-10 hours
H2RA: how early should i take this? 30 mins prior to event
H2RA: how many times a day can i take this max of 2x/day and a max of 2 weeks
H2RA: side effects HA, N.V, C/D ratidine: dark tongue and stool, cimetidine: hair loss
H2RA: drug interactions cimetidine interacts with warfarin, theophyline, phenytoin
PPI: duration and onset D: 12-24 hrs O:2-3 hours
PPI: when can i repeat treatment? 4 months
PPI: at what age can i take these? 18
PPI: side effects diarrhea, constipation, abdominal pain, headache,
PPI: drug interactions warfarin, cyclosporine, benzodiazapenes, phenytoin, methotrexate
PPI: geriatrics usually refer, more likely to have SE, stay away from Na-bicarbonate, H2RA and PPI are preferred
PPI: pediatrics H2Ra are not recommended, avoid bismuth subsalycilate, dont use PPI, refer if under 12`
PPI: pregnancy treat with lifestyle change, use antacids but not Na-bicarb, refer before using a H2RA, dont use PPI
PPI: lactation Mg and Al hydroxide are notsecreted into the milk, can be used, rantidine and famotidine are also ok, dont recommend PPI
exclusions for self treatment HB for over 3mo, Hb that continues for 2 weeks, pregnancy, children under 2
Int Gas: what can cause gas food, medical conditions, drugs, actions
Int Gas: symptoms belching, abdominal discomfort, bloating, nausea, bowel sounds, dyspepsia
Int Gas: non pharm reduce gas causing triggers, increase exercise, avoid tight clothes
Int Gas: pharm treatment - simethicone: can it be given to children yes, and infants
Int Gas: pharm treatment - simethicone: when is it used? when you have gas or arent sure what causing the gas
Int Gas: pharm treatment - activated charcoal: whats it recommended for odorous gas
Int Gas: pharm treatment - activated charcoal: can it be used in combo? yes, add to simethicone and thats a ok
Int Gas: pharm treatment - activated charcoal: should you recommend? nope lol
Int Gas: pharm treatment - alpha galactosidase: what is it used for?` helps with foods that contain oligosaccharides
Int Gas: pharm treatment - alpha galactosidase: are their special populations to watch out for caution in diabetics
Int Gas: pharm treatment - lactase replacement products: when can this be used people who are lactose intolerant
Int Gas: pharm treatment - probiotics: what is it used for GI complaints including intestinal gas and bloating
Int Gas: pharm treatment - probiotics: how long should it be used? 14 days trial period
Int Gas: pharm treatment - probiotics: who should this not be recommended to? people with pancreitis
Int Gas: exclusions for self treatment gas that persists for several months, severe symptoms, sudden change in lactation and abdominal pain, onset of symptoms in patients over 40, sudden change in bowel symptoms
Int Gas: what is Alpha galactosidase used for as a preventative measure to gas
Int Gas: what do you give if someone wants immediate relief from gas but cant associate gas with a particular food? simethicone
Created by: carlypentland



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