Heartburn

Question 1

What is heartburn?

Answer 1

burning in the stomach or lower chest, after 1 hour of eating, worsened by lying down

Question 2

What is GERD?

Answer 2

chronic condition of stomach acid entering the esophageous. Heartburn 2+/week

Question 3

What is dyspepsia?

Answer 3

indigestion, early satiety, postprandial fullness, epigastric pain/burning

Question 4

When not to self treat heartburn?

Answer 4

dysphagia, odynophagia, vomiting, GI bleeding, unexplained weight loss, non cardiac chest pain, asthma, voice changes, lump in the throat, chronic cough, trouble sleeping, dental erosion

Question 5

non-pharmacologic tratments for heartburn

Answer 5

acupucture, melatonin, weight loss, no food before bed, elevate head, stop tobacco use, symptom diary, modify lifestyle, meditarenian diet

Question 6

treatment for mild-moderate HB or dyspepsia

Answer 6

antacid(rapid releif) or H2RA(slower releif)

Question 7

Side effects of antacids

Answer 7

Aluminum-constipation
magnesium-diarrhea

Question 8

When to avoid antacids?

Answer 8

dyspepsia, kidney dysfunction, if you take calium, magnesium if CrCl than 30 ML/min, sodium bicarb if sodium restriction…

Question 9

H2RA dosing

Answer 9

cimetidine 200 mg daily, famotidine 10-20 mg 1-2 times daily(max 40 mg in 24 hours)

Question 10

PPI Pharmacodynamics

Answer 10

onset: 1-3 hours, may take 1-4 days for full effect
duration: 12-24 hours

Question 11

Bismuth subsalicylate side effects

Answer 11

black colored tongue, stool, tinnitus

Question 12

Bismuth subsalicylate drug interactions

Answer 12

warfarin, tetracycline, methotrexate