Gastric Disorders 2

Question 1

brand name famotidine

Answer 1

pepcid

Question 2

brand name ranatadine

Answer 2

Zantac

Question 3

brand name cimetidine

Answer 3

Tagamet

Question 4

brand name omeprazole,

Answer 4

Prilosec

Question 5

brand name lansoprazole

Answer 5

Prevacid

Question 6

brand name dexlansoprazole

Answer 6

Dexilant

Question 7

brand name rabeprazole

Answer 7

Aciphex

Question 8

brand name esomeprazole/sodium bicarbonate

Answer 8

Zegerid

Question 9

brand name pantoprazole

Answer 9

Protonix

Question 10

brand name esomeprazole

Answer 10

nexuim

Question 11

medications safe in pregnancy

Answer 11

PPI

H2 receptor agents

Question 12

mild tx (GERD/gastritis)

Answer 12

1. Lifestyle
2. Antacids
3. H2 receptor agonist
4. PPI
5. Carafate
6. Bismuth
7. Misoprostol

Question 13

lifestyle modifications

Answer 13

eat smaller meals 
elimination acidic foods 
eliminate triggers
weight loss 
avoid lying down 2-3 hours after eating 
HOB 3-4 inches

Question 14

antacids

Answer 14

rapid relief of heartburn
appropriate for occasional GERD

last <2 hrs

Tums, Rolaids, Maalox, Gaviscon

Question 15

antacids to watch in CKD

Answer 15

those with MG

Question 16

H2 receptor agonists MOA

Answer 16

block effect of histamine on gastric cells

decreased histamine req. to make acid + elimination of potentiation of Ach and gastrin in acid production

Question 17

H2 receptor antagonists used

Answer 17

Pepcid (preferred)
Axid
Tagamet
Zantac

-dine

Question 18

H2 receptor antagonists act when? who can’t use?

Answer 18

30 min until action

dose adjust in CKD

Question 19

Se of H2 blockers

Answer 19

B12 deficiency
AMS

IV: sinus Brady, hypotension, AVB, QT prolongation

Question 20

PPIs use

Answer 20

most powerful
take ON EMPTY stomach

need some acid to work (cant take with H2 blocker)

Question 21

PPIs special populations

Answer 21

OK in CKD, Pregancy

not okay in liver dz

Question 22

PPIs used

Answer 22

Prilosec 
Prevacid
dexilant 
aciphex
protonix
nexium/zegerd

Question 23

PPI in children

Answer 23

> 1 mo: Prilosec
3 mo: Prevacid
12 yrs: dexilant

Question 24

ADR of PPI

Answer 24

increased C Diff diarrhea

increased osteoporosis related factors

hypomagnesemia

impaired B-12

possible increased risk of CKD

Question 25

rare ADR of PPI

Answer 25

DILE/lupus worse
increased risk fo dementia
increased risk of gastric tumor

rebound hyper secretion if stopped abrupbtly

Question 26

Carafate

Answer 26

ulcer adherent complex

protects ulcer from acid/pepsin/bile (allows it to heal)

stimulates angiogenesis

Question 27

bismuth

Answer 27

surpasses h. pylori, doesn’t inhibit or neutralize gastric acid

turns stool back

Question 28

misoprostol

Answer 28

prostaglandin E hints acid secretion and enhances mucosa defense

prevent NSAID gastritis

can’t be given to women of childbearing age not on BC

Question 29

gastritis tx algorithm

Answer 29

tx with meds on daily basis for freq. symptoms

PPI and H2s can’t be combined and antacids should not be used with PPI

Question 30

inadequate response or no response in gastritis tx

Answer 30

increase PPI to bid or add adjunct tx

endoscopy (reflux esophagitis, GI lesion, complication of GERD)

Question 31

nissen fundoplication

Answer 31

surgical tx of Gerd

pull stomach up to reinforce LES

Question 32

duration of PPI or H2 blocker in PUD

Answer 32

gastric ulcer: 8 weeks

duodenal ulcer: 4 weeks

Question 33

management of NSAID ulcer

Answer 33

reduction to lowest effective dose
administration with meals
concomitant PPI or Cytotec

Question 34

when to do repeat EGD

Answer 34

gastric ulcers, 6-8 weeks after tx over to document heal/rule out CA