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Pharm Practice II > Chapter 13: Heartburn and Dyspepsia > Flashcards

Chapter 13: Heartburn and Dyspepsia Flashcards

1
Q

what is the medical term for heartburn?

A

pyrosis

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2
Q

heartburn is the main symptom of what disease?

A

gastroesophageal reflux disease (GERD)

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3
Q

what does dyspepsia mean?

A

discomfort or pain that occurs in the upper abdomen

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4
Q

dietary factors that may contribute to heartburn and GERD?

A 
alcohol
caffeine
chocolate
citrus
fatty foods
spicy foods
sugar
mint
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5
Q

lifestyle factors that may contribute to heartburn and GERD?

A

obesity
smoking
stress

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6
Q

heartburn symptoms occurring two+ times a week are suggestive of?

A

GERD

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7
Q

what are some “alarm symptoms” of heartburn?

A 
dysphagia (difficulty swallowing)
odynophagia (painful swallowing)
vomiting
GI bleed
unexplained weight loss
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8
Q

what is dysphagia?

A

difficulty swallowing

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9
Q

what is odynophagia?

A

painful swallowing

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10
Q

what is PUD?

A

peptic ulcer disease

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11
Q

what is a good recommendation for a pt for rapid relief of symptoms of heartburn?

A

antacids

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12
Q

what is a good recommendation for longer-lasting symptom relief of infrequent heartburn or dyspepsia?

A

histamine type 2 receptor antagonists (H2RAs)

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13
Q

patient should not exceed __ days of self-treatment with an antacid or H2RA w/o consulting PCP

A

14

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14
Q

what’s a good recommendation for treating frequent heartburn (2 or more x/wk) and is taken daily?

A

proton pump inhibitors (PPIs)

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15
Q

patient should not exceed __ days of self-treatment with a PPI and should not use again for __ months

A

14, 4

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16
Q

what is a lifestyle modification to recommend a pt w/ heartburn or dyspepsia who is overweight?

A

weight loss

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17
Q

what is a GERD pillow?

A

foam wedge placed beneath torso and head to decrease symptoms at night

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18
Q

if pt is experiencing mild, infrequent heartburn, what is the recommendation?
if pt sees no improvement, what else can they do?

A

lifestyle/dietary changes and-
antacid, low-dose H2RA, or combination of the two

use a PPI or see Dr

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19
Q

if pt is experiencing moderate, infrequent heartburn, what is the recommendation?
if pt sees no improvement, what else can they do?

A

lifestyle/dietary changes and-
antacid or high-dose H2RA

use a PPI or see Dr

20
Q

if pt is experiencing heartburn 2 or more times a week, what is the recommendation?

A

lifestyle/dietary changes and-

PPI daily for 14 days or H2RA as needed

21
Q

what are the exclusions for self-treatment of heartburn?

A
  • HB lasting more than 3 months
  • HB while taking correct dosing of H2RA/PPI
  • HB continuing after 2 weeks w/ H2RA/PPI
  • HB occurring when taking H2RA/PPI
  • Severe HB or dyspepsia
  • HB at night
  • Difficulty/pain swallowing solid foods
  • vomiting blood or black material
  • unexplained weight loss
  • wheezing, coughing, choking
  • continuous nausea, vomiting, or diarrhea
  • chest pain with sweating, shortness of breath
  • adults over 45 with new-onset dyspepsia
22
Q

how quickly do antacids work?

duration of relief?

A

less than 5 minutes

20-30 minutes

23
Q

how quickly do H2RAs work?

duration of relief?

A

30-45 min

4-10 hours

24
Q

how quickly do H2RA + antacid work?

duration of relief?

A

less than 5 minutes

8-10 hours

25
Q

how quickly do PPIs work?

duration of relief?

A

1-3 hours

12-24 hours

26
Q

what’s a good diet for lowering risk of GERD?
what should pts do to keep track of/determine foods, beverages, and activities that correlate w/ symptom onset and severity?

A

Mediterranean diet

Symptom diary

27
Q

how do antacids work in the stomach?

A

antacids contain basic ingredients to react with stomach acid to make the stomach less acidic

28
Q

what are the adverse effects of antacids?

A

nausea bloating or gas, but usually well-tolerated

29
Q

what are common side effects of antacids containing calcium carbonate and sodium bicarbonate?

A

belching and flatulence

30
Q

antacid-asprin combination products should not be used for patients with risks of?

A

bleeding risks or salicylate sensitivities

31
Q

what other acid can be taken with an antacid to provide better symptomatic relief than just antacid alone?

A

Alginic acid

32
Q

what are the primary ingredient(s) found in pepto-bismol ultra liquid?
what is dosage?
max per day?

A

bismuth subsalicylate
15 mL q30min prn
8 doses (120 mL)

33
Q

what are the primary ingredient(s) found in pepto-bismol chewable tablets?
what is dosage?
max per day?

A

bismuth subsalicylate
chew or dissolve 2 tabs every 30-60min prn
16 tabs

34
Q

what are the primary ingredient(s) found in tums extra strength tablets?
what is dosage?
max per day?

A

calcium carb
chew 2-4 tabs prn
10 tabs

35
Q

how to take cimetidine?

max per day?

A

1 tab w/ glass of water

2 tabs

36
Q

how to take famotidine?

max per day?

A

1 tab w/ glass of water

2 tabs

37
Q

how to take omeprazole?

max per day?

A

1 tab w/ glass of water 30 min before morning meal for 14 days
1 tab

38
Q

how to take lansoprazole?

max per day?

A

1 cap w/ glass of water 30 min before morning meal for 14 days
1 cap

39
Q

how to take esomeprazole?

max per day?

A

1 cap w/ glass of water 30 min before morning meal for 14 days
1 cap

40
Q

what are the adverse effects of H2RAs?

A

none, they are usually well-tolerated

41
Q

common side effects of H2RAs?

A

headache, diarrhea, constipation, dizziness, and drowsiness

42
Q

adverse effects with short-term use of PPIs are?

A

uncommon

43
Q

what are the names of all the antacids?

A

sodium bicarb.
calcium carb
magnesium hydrox.
aluminum hydrox.

44
Q

what are the names of all the H2RAs?

A

cimetidine

famotidine

45
Q

what are the names of all the PPIs?

A

omeprazole
esomepreazole
lansoprazole

Pharm Practice II (15 decks)

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