dyspepsia Flashcards
name alginates and antacids
gaviscon
peptac
indications for alginates and antacids
- GORD
- Dyspepsia
MOA antacid and alginates
- compound prep with alginate + 1/more antacids e.g. na bicarb, ca carb, mg or al salts
- antacids buffer stomach acids
- alginates increase viscosity of stomach contents - reduces reflux back into oesopahgus. after reaction with stomach acid = floating raft seperating contents from go junction,
- also inhibit pepsin production
- antacids alone - stm relief of dyspepsia
SE alginates and antacids
- mg salts; diarrhoea
- al salts - constipation
in infants what should you not give with alginates
- thickened milk preperations - abdo discomfort
what patients should you use na/k prep alginates/antacids more carefully in
- fluid overload an dhyperk e.g. renal failure
what should diabetics be careful of with antacids
some preps contain sucrose –> hyperglycaemia
divalent cations in compound alginates can reduce the absorption of which drugs
- ACE-i
- Tetracyclines
- cephalosporins
- cipro
- bisphosphonates
- digoxin
- levothyroxine
- PPI
what drugs has increased excretion due to antacids
- aspirin and lithium
how far apart should you take itneracting drugs from an antacid
2hrs
name some h2 receptor antagonists
ranitidine
h2 receptor anatagonists Indications
- peptix ulcer disease
- GORD and dyspepsia
H2 r antag MOA
- Reduce gastric acid secretion. partial block of PP
H2 antag SE
- Bowel disturbance (diarrhoea or constipation)
- headache and dizzy
who should you reduce dose of H2 antag in
- renal fialure as renal excretion.
what should you do for patients who have GORD and are undergoing general anesthetic surgery? and why
- prescribe PPI/h2rAnt preop to avoid risk of aspiration pneumonia if getting general anesthetic.
name PPI
Omeprazole
lansoprozole
ezomeprazole
pantoprozaole
indicatiosn for PPI
- prevent and treat Peptic ucler disease
- gord and dyspepsis
- H Pylori eradication
MOA PPI
- reduce gastric acid secretion by irreversible inhibition h+/k+ ATPASE in gastric parietal cells.
SE PPI
- Gi disturbance
- headache
- reduction in gastric pH = PPIs reduce bodys host defence against infection - high risk c diff
- prolonged use; hypomg - tetany and ventricular arrythmia
PPI caution use in..
osteoporsis - increase risk of fracture if PPI at high dose in elderly
PPI interactions
omeprazole - reduce effect of clopidogrel by activating cyp450.
