Gastrointestinal Flashcards
Do not use calcium based antacids in pts with
Hypercalcemia or renal calculi
Magnesium or aluminum based antacids are contraindicated with patients with:
RENAL failure
________ based antacids cause diarrhea
Magnesium
_______ based antacids cause constipation
Aluminum and calcium
Administer antacids:
Separated by at least 2 hours of other drugs. Affects the absorption of MANY drugs
First line therapy for GERD
Depends on severity of symptoms.
Mild/moderate: H2
Severe: PPI
Bismuth black box warning:
BLACK tongue or gray-black stools
Travelers diarrhea
Bismuth subsalicylate with each meal and at bedtime to prevent diarrhea
Treatment for NSAID ulcers or duodenal ulcers
Sucralfate or misoprostol
- do not use misoprostol during pregnancy!
H2RA inhibitors
Ranitidine
Famotidine
ADR with H2RA
(Ranitidine/ famotidine)
-gynecomastia
-mental confusion, agitation, psychosis, depression
- agranulocytosis, thrombocytopenia, aplastic anemia
Tardive dyskinesia can happen with:
Metoclopramide
PPIs
Omeprazole, pantoprazole
PPIs treat
GERD
PUD
Duodenal ulcers caused by H. Pylori
Long term use of PPI ADR:
Nutrient deficiencies
Osteoporosis
Gastric cancer
CKD
_________ interacts with omeprazole
Plavix!!
Treatment of duodenal ulcers
PPI + ABX
GERD tx with PPI
8 week course then wein off
First line choice for short term rapid response laxative
Stimulants : bisacodyl, senna
Mild GERD treat:
Antacids + H2 agonists
Moderate-severe GERD treat
PPI x 8 weeks then wein off.
If unresolved- refer to specialist
PUD treatment (steps)
Step 1: lifestyle changes then OTC antacids/ H 2 blockers
Step 2: H. Pylori testing. Treat with PPI.
Step 3: treat H. Pylori
Treat H Pylori with:
Triple therapy:
PPI + metronidazole + amoxicillin for 10-14 days
Quadruple therapy for pts that fail first line
