MCP: Upper GI Flashcards
1
Q
Heartburn
A
- Burning Sensation
- Discomfort behind breastbone
- Caused by acid reflux or regurgitation
- Symptom of GERD
2
Q
Dyspepsia
A
- Persistent discomfort in upper abdominal area
- Bloating
- Early satiety
- Nausea and Vomiting
3
Q
Heartburn vs. GERD
A
- Heartburn
- Simple: Generally mild, associated with diet, and episodic
- Frequent: Heartburn 2x or more/week
- GERD
- Symptoms or esophageal damage that results from reflux of gastric contents into the esophagus
- Most common symptoms of GERD: heartburn that is frequent and persistant (3 mo)
4
Q
GERD: Typical and Atypical Symptoms
A
- Typical Symptoms:
- Heartburn
- Regurgitation
- Hyper-salivation
- Belching
- Atypical Symptoms
- Dental errosions
- Chest pain
- Pharyngitis
- Hoarseness
- Chronic Cough
- Non-allergic asthma
5
Q
When to refer:
A
- Severe, recurrent, persistent symptoms
- Dysphagia: difficulty swallowing
- Chest pain
- Bleeding
- Bloody stool, black and tarry
- Coffee ground vomit
- Unexplained weightloss
- Elderly
- Consistent N/V/D
6
Q
Lifestyle Recommendations
A
- Don’t eat before bedtime/lying down
- Elevate head of bed (~6 inches)
- Weight Loss
- Smoking cessation
- Reduce portion sizes
- Avoid trigger foods
- Fatty foods
- Chocolate
- Spicy Foods
- Citrus
- Coffee
- Salt
- EtOH
- Avoid trigger medications
- NSAIDs (especially aspirin)
7
Q
Antacid: MOA
A
- Neutralizes stomach acid by increasing gastric pH
8
Q
Antacid: Indications
A
- Mild, infrequent heartburn/dyspepsia
9
Q
Antacid: Onset
A
Instant
10
Q
Antacid: Duration
A
- 20 min (empty stomach)- 3 hours (full stomach)
- What affects the duration of all antacids?
- Food
11
Q
Sodium Bicarbonate
- Dissolution rate at gastric pH
- Duration
- Side effects
A
- Alka Seltzer
- rapid dissolution
- short duration
- Side effects:
- Sodium overload
- Alkalosis
- Milk-Alkali syndrome
- Not for pregnant or elderly
12
Q
Calcium Carbonate
- Dissolution
- Duration
- Side Effects
A
- Max 2500 mg
- Slower dissolution
- Long duration
- Side Effects:
- Constipation
- Hypercalcimia
- Milk-alkali syndrome
- build up Ca2+, damage kidney
13
Q
Aluminum Hydroxide:
- Dissolution
- Duration
- Side Effects
A
- Slower dissolution
- longer duration
- Constipation
14
Q
Magnesium Hydroxide
- Dissolution
- Duration
- Side Effects
A
- rapid dissolution
- short duration
- diarrhea
15
Q
Antacids Cautions/Contraindications
A
- Regular use for 2 weeks
- Patients with hypercalcemia
- Toxicity with renal impairment
- Persons of advanced age, children, or pregnancy or breasfeeding women
- Calcium in pregnant/breastfeed (not Nabicarb)
- Caution with Mg in elderly
- Al containing: Caution in patients predisposed to obstruction
- Elderly
- Dehydrated
- Reduced bowel motility (opiods)