Chapter 2.3 - Indigestion Flashcards
What are the symptoms of Indigestion/Dyspepsia?
Poorly localised upper abdominal discomfort - can be brought on by particular foods, excess food, alcohol or medication (aspirin)
What are the referral points for Indigestion?
- Age over 45 if symptoms develop for the first time
- Symptoms persistent or recurrent (longer than 5 days)
- Pain is severe
- Blood in vomit or stools
- Pain worsens on effort
- Treatment has failed
- Adverse drug reaction is suspected
- Associated weight loss
- Children
What can cause indigestion or predispose to it?
Diet - fatty foods and alcohol
Smoking
What medicines can cause it or other GI side effects?
NSAIDs - aspirin, ibuprofen
Iron
What is the treatment scale? After which referral to doctor
5 days
What treatment can be recommended? (2)
Antacids or H2 antagonists
What non-pharmacological advice can you give for indigestion? (3)
Smoking, Alcohol, Fatty Meals
Why would you recommend a liquid antacid over a solid preparation?
they are
easier to take, work quicker and have a greater neutralising capacity.
Their small particle size allows a large surface area to be in contact
with the gastric contents.
Antacids are best taken 1 hour after a meal. Why is this?
Because the rate of gastric emptying has then slowed and the antacid will remain in the stomach for longer.
Taken at this time, antacids may act for up to 3 h compared with only 30 min–1 h if taken before meals.
Name some examples of antacids. (4)
Sodium bicarbonate
Aluminium Salts
Magnesium Salts
Calcium Carbonate
Which antacid would be given to those who are
a. constipated
b. have diarrhoea
a. Magnesium salts
b. Aluminium salts
What can long term use of sodium bicarbonate lead to? (2)
Systemic alkalosis
Renal damage
What interactions can occur with antacids?
Because antacids raise the gastric pH = can interfere with Enteric coatings on medications (inactivation)
Reduce the absorption of: tetracyclines ketoconazole penicillamine rifampicin azithromycin
Decrease in iron absorption if taken at the same time
What is the interaction between sodium bicarbonate and lithium?
Increases the excretion of lithium and lowers the plasma level = reduction in lithium’s therapeutic effect
therefore shouldn’t be recommended.
Why is there a decrease in iron absorption if taken at the same time as an antacid?
The effect is caused by the formation of insoluble iron salts due to the changed pH
