Dyspepsia/Indigestion Flashcards
Respond to symptoms, learn of the cause of the minor ailment, learn referral points and differential diagnosis, recommend treatment and provide lifestyle advice
Name 3 causes of dyspepsia
GORD Peptic ulcer (gastric or duodenal) Hiatus hernia IBS Non-ulcer dyspepsia
Name 3 symptoms of dyspepsia
Upper abdominal pain and discomfort
Heartburn
Nausea and vomiting after eating
Acid Reflux
Name 3 referral points when a patient presents with dyspepsia
Bleeding Dysphagia Persistent vomiting Iron deficiency anaemia If >40 and first instance of dyspepsia - cancer? Unintentional weight loss - cancer?
Name 3 differential diagnosis
Cardiac pain (on exertion and radiates)
Medication side-effect - NSAIDs, CS, Fe, Bisphosphonates
IBS - refer for diagnosis
Biliary Colic (right upper abdominal pain)
Appendicitis (dull abdominal pain initially that becomes sharp lower right abdominal pain)
Pancreatitis (upper abdominal pain that radiates to the back)
Peptic Ulcer (gastic or duodenal)
Name all four OTC treatment options
Antacids, Alginates, H2 antagonist and PPI
What is the MOA of Antacids and name the two commonly used salts and common OTC products
MOA - Buffer mechanism
Al salts and Mg salts
Antacid counselling points
Take antacids after food or at night Al salts can cause constipation Mg salts can cause diarrhoea Bismuth salts can cause dark stools Antacids impair the absorption of other medications due to its MOA
What is the MOA of Alginates and name common OTC products
MOA - Raft
Gaviscon, bicarbonates
What is the MOA of H2 antagonists and name the OTC product and counselling points
MOA - inhibit parietal cells and reduce acid secretion
Ranitidine - Zantac 75mg Relief (bd max), 16+ years, avoid in pregnancy or breastfeeding, if no improvement after6 days see GP
What is the MOA of PPI and name the OTC product and counselling points
MOA - inhibit parietal cells and reduce acid secretion
Esomeprazole - Nexium 20mg (od), takes 2-3 days to have effect, 18+, max 4 weeks, if no improvements after 2 weeks see GP
Lifestyle advice
Smoking cessation
Weightloss
