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GERD/PUD

Important Info

QuestionAnswer
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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