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GERD/PUD
Important Info
| Question | Answer |
|---|---|
| Alarm symptoms for GERD | GI bleeding, black stools, vomiting blood |
| What is Zollinger-Ellison? How do you treat? | hypersecretion of acid by a tumor. Give PPI BID |
| Definition of peptic ulcer disease and causes | mucosal erosions. May be due to H. pylori, aspirin, NSAIDs, corticosteroids |
| Antacids that are renally cleared (AVOID in renal dysfunction) | Aluminum (AlOH3) and Magnesium (MgOH2) |
| Antacid to Avoid in Pregnancy | Sodium containing! (can cause fluid overload/metabolic alkalosis) NaHCO3 (Sodium Bicarbonate). Also avoid in HTN and CHF |
| Major side effects of Aluminum containing antacids | Constipation, Aluminum intoxication(renal) |
| Major side effect of Calcium containing antacids | Constipation (Calcium=Constipation)** |
| Major side effect of Magnesium containing antacids | Diarrhea! (Remember, Mag Citrate treats constipation...) |
| 3 Major drug interactions with antacids | Antibiotics: Tetracyclines(chelate), Quinolones Levothyroxine Things that need acidic environment: Iron, Ketoconazole, itraconazole |
| Gaviscon | Alginic Acid |
| Alginic Acid MOA | Floats on top of the stomach to protect the esophageal mucosa... therefore requires an upright position (no impact on nocturnal GERD) |
| H2RAs = All are Pregnancy Category ___ | B |
| Tagament | Cimetidine |
| Zantac | Ranitidine |
| Pepcid | Famotidine |
| Axid | Nizatidine |
| Cimetidine (Tagament) - unique side effects; Drug interactions, max dose | SE: gynecomastia, galactorrhea; CYP1A2 Inhibitor (increases warfarin/theophylline), MDD=800 mg |
| Ranitidine(Zantac) - DOC for..., max dose | DOC in pregnancy, MDD=300 mg |
| Famotidine (Pepcid) - Max dose | MDD=40mg |
| Nizatidine (Axid) - unique point, Max dose | Unique: only one not available IV/IM, MDD= 300 mg |
| H2RA dose comparison | Cimetidine 400=famotidine 20 = Nizatidine 150=Ranitidine 150 |
| H2RA Class effects | CNS (dizzy, sedation, confusion, can worsen dementia), all pregnancy category B, Dose adjust for renal dysfunction!!!! <50 ml/min for most (<30 ml/min for cimetidine) |
| PPI MOA | Irreversibly block H+/K+ ATPase in the gastric parietal cells |
| PPI Administration time and reason | 30 minutes before breakfast - because your body starts making proton pumps in the morning, drug is then onboard to work when they become active with eating |
| Prilosec | omeprazole |
| Zegerid | omeprazole/sodium bicarb |
| Nexium | esomeprazole |
| Vimovo | Esomeprazole/naproxen |
| Prevacid | Lansoprazole |
| Dexilant | Dexlansoprazole |
| Protonix | Pantoprazole |
Created by:
naplexreviewgirl
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