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Pharmacy 255 > Dyspepsia > Flashcards

Dyspepsia Flashcards

1
Q

What is the difference between GERD and Dyspepsia?

A

GERD is a specific cause of dyspepsia
Dyspepsia is epigastric pain and discomfort

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2
Q

What is the most common cause of dyspepsia?

A

Functional dyspepsia

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3
Q

What is functional dyspepsia?

A

No abnormality found for their dyspepsia

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4
Q

What are risk factors for dyspepsia?

A

diet
drugs
H pylori
smoking
alcohol

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5
Q

What are the drugs that can cause dyspepsia? What is the mechanism?

A

Bisphosphonates
iron
NSAID
Potassium
Change motility or irritant (this is for Iron, NSAID, Potassium)

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6
Q

What is the main sx of GERD?

A

heartburn and regurgitation

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7
Q

What are alarm sx?

A

Vomiting
Bleeding/anemia
Abdominal mass/weight loss
Dysphagia/odynophagia

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8
Q

What are other bad risk factors of dyspepsia? Why?

A

greater than 50 or greater than 60
GI cancer

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9
Q

Which is more serious erosive or non erosive esophagitis?

A

erosive

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10
Q

What are some causes of GERD?

A

bad sphincter
over eat/pregnancy= high pressure
hiatal hernia= diaphragm cant close sphincter
delayed gastric emptying
too much acid

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11
Q

What drugs can induce GERD and what is MOA?

A

anticholinergic and benzos
MOA= slow peristalsis or relax sphincter

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12
Q

Sx of GERD?

A

belch, water brash, chest pain, cough, throat clearing, dental erosion

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13
Q

What would indicate moderate-severe GERD?

A

nocturnal symptoms, >3 x a week

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14
Q

Complications of GERD?

A

esophagitis, barretts esophagus, cancer

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15
Q

What is refractory GERD?

A

failed PPI after good 4-8 weeks

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16
Q

How can we diagnose GERD?

A

endoscopy
barium swallow
Manometry or pH monitoring

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17
Q

What are some lifestyle mods for GERD?

A

lose weight, stop smoking, elevate head

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18
Q

Fastest treatment for GERD?

A

antacid

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19
Q

What are the alginates and what is their role?

A

Sodium alginate- makes foamy that makes it feel better
adjunctive

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20
Q

What are the counselling tips for sodium alginate?

A

take 1 hour after eating

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21
Q

Who cant get antacids?

A

avoid in renal

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22
Q

MOA of antacids?

A

neutralizes acid

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23
Q

When to take antacids?

A

30-60 min after meal

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24
Q

What is common s/e of aluminum antacids?

A

constipating and bone issues

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25
Q

Main s/e of magnesium antacids?

A

laxative

26
Q

Common drug interactions with antacids and how to fix?

A

antibiotics, Iron, bisphosphonates, levothyroxine
space by 1 hour before or 2 hours after

27
Q

What are the H2RAs? MOA?

A

Cimetidine, end in tidine
MOA- block histamine relesae= less acid

28
Q

What is dose of H2RA for GERD and not GERD?

A

GERD has lower dose

29
Q

S/e of H2RAs?

A

gi but cimetidine is poorly tolerated

30
Q

Which H2RA is not tolerated and why?

A

cimetidine because more CNS effect also more DI

31
Q

What is the main issue with H2RA?

A

tachyphylaxis after 8 weeks

32
Q

Which pantoprazole sodium is better for the night/ longer duration?

A

magnesium

33
Q

What is one PPI doesnt work for GERD?

A

try a different after 4-8 weeks

34
Q

When to give PPI for GERD?

A

30 min before meal

35
Q

How long to see benefit with PPI?

A

3-5 days

36
Q

In relation to standard dosing and double dosing, which should we do?

A

standard dose

37
Q

How do we adjust dose in renal patients with PPI?

A

NOTHING

38
Q

s/e of PPI?

A

metalic taste, ND, C diff, colitis, polyps, B12 deficiency, cancer

39
Q

If you experience s/e on one PPI, does a switch help at all?

A

yes

40
Q

What PPI is worst for causing colitis?

A

lansoprazole

41
Q

Which PPI do we chose if we want to avoid DI?

A

pantoprazole, rabeprazole, dexlansoprazole

42
Q

What are the prokinetic drugs? MOA? Which is less tolerated

A

domperidone and metoclopramide
MAO- dopamine antagonist= stim motility
less tolerated is metoclopramide

43
Q

When do you administer prokinetic drug?

A

within 30 min of eatingWH

44
Q

Who cant use metoclopramide?

A

gi obstruct, seizure, parkinsons

45
Q

Who cant take domperidone?

A

gi obstruction, QT if at high doses

46
Q

s/e of domperidone

A

dr mouth, QT, gynecomastia

47
Q

S/e of metoclopramide?

A

drowsy, muscle weak, pseudo parkinsons

48
Q

What enzyme does metoclopramide use?

A

2D6

49
Q

What enzyme does domperidone use?

A

3A4

50
Q

What is a predictor of failure on PPI?

A

weakly acidic or alkaline reflux

51
Q

Which people should be deprescribed off of PPI?

A

responded, proper duration, no sx for 3 days, no H pylori

52
Q

Who should never be deprescribed?

A

Barretts, chronic NSAID use includes ASA, severe esophagitis, bleeding ulcer

53
Q

What do we do for functional dyspepsia?

A

PPI for 8 weeks, H pylori testing, add TCA, add prokinetic

54
Q

What signs in a baby should be treated for GERD?

A

loss of weight, blood in stool, irritable when taking food

55
Q

What signs in a baby make it more serious than GERD?

A

forceful vomit, fever, distention

56
Q

Who has a lower chance of having GERD, breast or bottle fed?

A

breast

57
Q

What do we do for infant with GERD?

A

PPI for 2 weeks if improve do for 3 months

58
Q

If pregnant and have GERD what should you do? What about lactation

A

pregnant= avoid sodium bicarb and magnesium trisilicate
lactate= pantoprazole

59
Q

What drugs can cause esophagitis?

A

Doxycylcine, Potassium tab, NSAIDs, Bisphosphonates

60
Q

How can we lower DI esophagitis?

A

don’t lie down, water, smaller pills

61
Q
A

Pharmacy 255 (16 decks)

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