GERD Flashcards
what medications can decrease LES ? (12)
Progesterone Anticholinergics Nitrates Dihydropyridine Ca blockers Alcohol
Barbituates
Estrogen
Nicotine
Dopamine
Caffeine
Theophylline
Tetracycline
What foods decrease LES pressure
Fatty meals Peppermint Chocolate Garlic Onions Peppers
what meds directly irritate esophageal mucosa
alnedronate Aspirin NSAIDs Iron Quinidine potassium Chloride
food that directly irritate the esophageal mucosa
spicy food
orange juice
tomato juice
coffee
what are the esophageal symptoms
pyrosis (heart burn
regurgitate acid into mouth
what are extra esophageal symptoms of gerd
chronic couch
sore throat
non-cardiac chest pain
asthma
gerd can be a co-factor in patients with what
asthma or layngitis
what are the alarm symptoms of gerd
dysphagia odynophagia choking weight loss GI bleeding chest pain n/v diarrhea
when should gerd be referred to physician (7)
- alarm symptoms present
- extra-esophageal or atypical symptoms without heartburn or regurgitating acid
- duration (risk of barretts)
- not responsive to empiric treatment
- length of treatment
- co-morbidity
- severe symptoms (MI or vomit blood…)
what are 4 nonpharm treatments of gerd?
- weight loss for BMI over 25
- elevate head of bed
- avoid meals 2-3 hours before lying down
- avoid certain foods such as chocolate, or spicy things
what are the atypical symptoms of gerd
dyspepsia epigastric pain nausea bloating beltching
which ppi has the least amount of drug interactions
pantoprazole
how should ppis be taken for gerd
begin with once daily dosing
take 30-60 minutes prior to meal
how should h2ras be taken for gerd
bid without regard to meals
renally dosed
tachyphylaxis of pH control possible after 4 weeks
what are the most potent h2ras for gerd
famotidine and ranitidine
