GORD and ulcers

Question 1

side effects of antacids?

Answer 1

magnesium = laxative effect
aluminum = constipation
calcium = rebound acid secretion

Question 2

when should sodium containing antacids NOT be used?

Answer 2

patients with renal, liver or heart conditions
pregnancy
hypertension

Question 3

what are examples of histamine h2 antagonists?

Answer 3

ranitidine, Cimetidine, Famotidine

Question 4

side effects of histamine h2 antagonists?

Answer 4

headache, diarrhoea, dizziness,

occasionally rash, altered LFTs

Question 5

interactions of histamine h2 antagonists?

Answer 5

Cimetidine interacts with:
– warfarin – inhibits metabolism. ↑INR
– phenytoin, carbamazepine, valproate – inhibits
metabolism. ↑plasma concentrations
– theophylline – inhibits metabolism. ↑plasma
concentrations
– sildenafil - ↑plasma concentrations

Question 6

examples of PPI?

Answer 6

Esomeprazole, Lansoprazole, Omeprazole,

Pantoprazole, Rabeprazole

Question 7

side effects of PPI?

Answer 7

constipation, diarrhoea,

headache, dizziness

Question 8

risk of long term use with PPI?

Answer 8

Associated with an increased risk of adverse events
• Achlorhydria – low gastric acid production is associated with
increased risk of:
– Gastric cancer
– H pylori infection (particularly the elderly)
– Pneumonia
– Clostridium difficile infection (PPI use was associated with
a 42 per cent increase in the risk of recurrent CDI)
– bacterial overgrowth and reduced calcium absorption
leading to hip fracture.

Question 9

interactions with PPI?

Answer 9

Interactions include:
– Antiretrovirals
– Methotrexate
– Citalopram
• Omperazole is predicted to decrease efficacy Clopidogrel –
manufacturer advises avoid