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