Gi System - Gastric Acid Disorder Flashcards
Urgent Referral for Dyspepsia/Gord?
Bleeding
Over 55
Weight loss unexplained
BOW
Uninvestigated Dyspepsia treatment plan?
PPI for 4 weeks
If doesn’t work: H Pylori Test
Investigated Functional Dyspepsia however cause not known?
Test for H Pylori
If not infected 4 weeks PPI or H2 antagonist
H Pylori test?
Urea (13c) Breath Test
Or
Stool Helicobacter Antigen Test (SAT)
When should PPI and Abx be stopped before a H pylori test?
PPI stopped 2 weeks before
Abx stopped 4 weeks before
H Pylori treatment? Duration?
PPI Twice daily
Amoxicillin 1000mg BD
Clarithromycin 500mg BD
Metronidazole 400mg BD
7 days
GORD - Gastro Oesphagul Reflux disease
What increases it from happening?
Fatty Foods
Pregnancy
Hernia
Family History
Stress/Anxiety
Obesity
Drugs
Smoking
Alcohol
Drugs which can increase GORD?
CCB
Statins
ACE inhibitors
Nitrates
Also cause Oesphagul irritations?
Bisphosphonates
TCAS
Corticosteroids
Benzos
Abx (Clindamycin and Tetracycline)
Nitrates increase GORD how?
Loosens sphincter
Therefore more acid Reflux
Uninvestigated GORD treatment?
4 weeks PPI
How to treat confirmed GORD?
4-8 weeks of PPI
Gord during Pregnancy? 3 steps?
- Dietary and lifestyle
- Antacids and Alginate
- Omeprazole or Ranitidine
Magnesium containing antacids laxative or constipation effect?
Laxative effect
“L” next to “M” in alphabet
Aluminium containing antacids laxative or constipation effect?
Constipating Effect
“C” next to “A” in alphabet
Calcium containing Antacids affects reflux how?
Induces rebound acid secretion effect
What increases viscosity of stomach contents to prevent acid bounce back?
Antacids + Alginate
Forms viscous gel Raft - floats on surface of stomach contents prevent acid bounce back
Antacids and Hypertension & lithium interaction?
Due to sodium content
Contraindicates with Lithium/Hypertension
Hypernatraemia
Low sodium antacid available?
Co-magaldrox
Which drugs impair antacid absorption?
Bisphosphonates
Tetracyclines
Ciprofloxacin
PPI MHRA warning?
Low risk of Subacute Cutaneous Lupus Erythematosus
(Which is an autoimmune disorder causing skin sores/rashes)
PPI electrolyte imbalance and therefore risk of what condition occurring?
Hypomagnesaemia
Increasing Risk of Fractures/Osteoporosis
PPi and C. difficile
Ppi increase risk of C Difficile
Esomeprazole/Omeprazole with Clopidogrel?
Do not use together!
Use Lansoprazole instead
