GORD/peptic ulcers/nusea/vomitting

Question 2

management of patients with dyspepsia, Gastro Oesophageal Reflux Disease (GORD), peptic ulcer disease; nausea and vomiting; constipation and diarrhoea.

Answer 2

• Antacids,
• proton pump inhibitors (PPIs),
• ## H2 receptor blockers

Question 3

what is the role of Antacids and H2 receptor antagonists

Answer 3

Acts by neutralizing the acid in the stomach, therefore, helps relieve pain.

Question 4

Proton pump inhibitors

end in zole

Answer 4

Proton pump inhibitors such as
lansoprazole
rabeprazole,
esomeprazole
omeprazole
pantoprazole
Works by decreasing the release of gastric acid.

end in ZOLE

used in GORD, peptic ulcer dises, pylori eradication

Question 5

what are the main 3 types of medication fro GORD, peptic ulcers, etc??

Answer 5

1. Antacids
2. H2 receptor antagonist
3. Proton Pump Inhibitor (PPI)

Question 6

list as much as you can about Antacids

Answer 6

Antacids
Indication:
- dyspepsia
- GORD
- PUD
Mechanism of action:
- neutralises the acid contents of the stomach
- best effect if taken 1-3 hours after meals
Adverse effects
- increased constipation for those containing Al or Ca
- increased diarrhoea for those containing Mg
- reduce oral medication effects and motabolism
Contraindication:
- have high sodium content, therefore avoid in heart failure
Examples:
- Aluminium hydroxide
- Calcium carbonate
- Magnesium hydroxide

Question 7

H2 receptor antagonist (-tidine)

Answer 7

Indication:
- dyspepsia, PUD, GORD
Mechanism of action:
- competitively block H2 receptors on parietal cells, preventing secretion of gastric acid
Examples:
- famotidine
- nizatidine
Adverse effects:
- generally well tolerated
- rarely cause hypersensitivity and interstitial nephritis
Pregnancy:
- more evidence that supports safety of famotidine, rather than nizatidine
Breastfeeding:
- safe

Question 8

Proton Pump Inhibitor (PPI) (-prazole)

Answer 8

Indication:
- dyspepsia
- GORD
- PUD
- H pylori eradication
Mechanism of Action:
- binds to the hydrogen/potassium pump in the cell membrane to inhibit stimulated gastric acid and basal acid secretions
Examples:
- pantoprazole
- lansoprazole
Adverse effects:
- generally well tolerated
- rarely causes electrolyte disturbances

Question 9

Helicobacter pylori-induced ulcers

Answer 9

**
Treatment regime for eradicating ulcers:
Without amoxicillin allergy:**
- PPI (standard dose BD)
- Clarithromycin (500mg BD)
- Amoxicillin (1g BD)

With amoxicillin allergy:
- PPI (standard dose BD)
- Clarithromycin (500mg BD)
- Metronidazole (400mg BD)

Question 10

Antiemetics

Answer 10

1. Dopamine antagonists
2. 5HT3 antagonists

Question 11

Dopamine antagonists

Answer 11

1.** Metoclopramide**
Adverse effects:

• Dizziness
• Akathisia
• Drowsiness
• ## HeadacheContraindications:
• Parkinson’s
• Depression
• People under 20

2. Prochlorperazine
   Adverse effects:

• Drowsiness
• Akithisia
• Parkinsonism
• Constipation
• Dry mouth

Contraindications:
- Parkinsons
- Depression

Question 12

Helicobacter pylori-induced ulcers

what is the tripple therapy

Answer 12

Treatment regime for eradicating ulcers:
Without amoxicillin allergy:
(tripple therapy)
- PPI (standard dose BD)
- Clarithromycin (500mg BD)
- Amoxicillin (1g BD)

With amoxicillin allergy:
- PPI (standard dose BD)
- Clarithromycin (500mg BD)
- Metronidazole (400mg BD)