GERD Flashcards
What drugs can worsen GERD?
What antacids to know about?
What to know about the H2RA’s?
Aspirin/NSAIDs, Bisphosphonates, Dabigatran, Estrogen products, fish oil products, iron supplements, nicotine replacement therapy, steroids, tetracyclines.
Calcium carbonate (tums), + magnesium (mylanta supreme) + simethicone (maalox advanced maximum strength). 4-6 times per day. Aluminum and magnesium can accumulate with severe renal dysfunction. Calcium:constipation. Magnesium:loose stools. Calcium is preferred in pregnancy.
Famotidine (Pepcid, Pepcid AC) can be an injection. Ranitidine (Zantac, Ranitidine Acid reducer), also an injection. Confusion risk factors are elderly, severely ill, renal impairment. Cimetidine at high doses can cause gynecomastia, impotence. Decrease dose when CrCl <50 mL/min. Avoid Cimetidine due to drug interactions and side effects.
What are the Oral PPI’s?
When should I take the PPI’s?
What are the side effects of the PPI’s?
Dexlansoprazole(dexilant), Esomeprazole (Nexium), Lansoprazole (Prevacid), Omeprazole (Prilosec), Pantoprazole (Protonix).
Dexilant is without regard to meals, Nexium is 60 minutes before breakfast, Lansoprazole before breakfast, Prilosec is before a meal.
Cdiff, osteoporosis related fractures, hypomagnesemia. Pantoprazole and esomeprazole are the only PPI’s available IV. Capsules can be opened and mixed in applesauce.
What to know about Metoclopramide?
What drugs require an acidic gut?
What is bismuth quad therapy?
Take 30 minutes before meals and at bedtime. Can cause tardive dyskinesia, EPS, parkinsonian-like symptoms, drowsiness, CNS side effects, CrCl <40 mL/min (use 50% of normal dose). Avoid with parkinson disease.
Antiretrovirals, Antivirals, Azole antifungals, Cephalosporins, Iron products, mesalamine, risedronate delayed release, Tyrosine kinase inhibitors, Bisphosphonates, Isoniazid, Mycophenolate, Quinolones, Sotalol, Steroids, Tetracyclines, Thyroid products.
Take for 10-14 days. Bismuth subsalicylate + metronidazole + tetracycline + PPI. Pylera is name. Do not use metronidazole if alcoholic, do not use tetracycline pregnancy.
What is concomitant therapy for H.Pylori?
What is Clarithromycin triple therapy?
What is misoprostol stuff?
Amoxicillin + Clarithromycin + Metronidazole + PPI. 10-14 days.
Take for 14 days. Amoxicillin + Clarithromycin + PPI. Penicillin allergy: metronidazole.
Prostaglandin E1 analog. Abortifacient, diarrhea, abdominal pain.
What to know about Sucralfate(Carafate)?
Before meals, constipation.
