Acid Secretion Drugs Flashcards

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1
Q

What is GORD?

A

Gastroesophageal reflux disease

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2
Q

What is the first line management of GORD?

A
Lifestyle changes:
Weight loss
Decrease alcohol 
Stop smoking 
Stop aggravating drugs e.g. NSAIDs 

May also want to test for H.pylori

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3
Q

What drugs can be used to treat GORD?

A

Antacids/alginates
H2 receptor antagonists
PPI

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4
Q

Give an example of an antacid

A

Gaviscon

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5
Q

Give an example of a H2 receptor antagonist

A

Ranitidine

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6
Q

Give an example of a PPI

A

Omeprazole
Lansoprazole
Esomeprazole

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7
Q

When might an urgent upper GI endoscopy by needed?

A
Red flag symptoms:
Haematemsis (blood in vomit)
Melaena
Weight loss
Abdominal mass 
>55 yrs 

Ongoing symptoms despite maximal treatment

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8
Q

When would you give H2 receptor antagonist?

A

GORD after lifestyle changes and antacids prove to be unsuccessful

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9
Q

What are the benefits of H2 receptor antagonists?

A
Freely available (OTC)
Cheap
Short half life 
Safe (minimal side effects and interactions)
80-90% acid suppression
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10
Q

After what treatment method would you try giving PPIs for GORD?

A

If H2 receptor antagonists are not working

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11
Q

What are the side effects of PPIs?

A
Diarrhoea 
Osteoporosis (long term)
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12
Q

What is the mechanism of action of PPI?

A

Bind to and block active proton pumps (which are activated post eating)
Complete acid suppression

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13
Q

Describe the effects of antacids

A

Works as buffer for temporary relief

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14
Q

Describe the effect of alginates

A

Viscous substance, forms a raft over denuded gastric mucosa, protecting it

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15
Q

How do you test for H.pylori infection?

A

Carbon 13 urea breath test
Or
Stool antigen test

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16
Q

What is the treatment for H.Pylori?

A

Triple therapy for 1 week BD:
Clarithromycin
Amoxicillin
Lansoprazole (PPI)

17
Q

What is the side effect of H.pylori treatment?

A

Diarrhoea

18
Q

How would you manage oesophagitits?

A

Need ongoing acid suppression

19
Q

How would you treat Peptic ulceration?

A

Stop NSAIDs
H2RA/PPI
Combine with antibiotics for H.pylori (covers all bases)