PPIs & dyspepsia Flashcards
Three cautions of PPIs
Masking signs of gastric cancer
Increase risk of C diff
Increase risk of fractures (esp over 1 years use in the elderly)
Use of PPIs in CF
Reduce the degradation of pancreatic enzymes
PPIs should always accompany what class of medication?
NSAIDS
alarm features for dyspepsia (4)
weight loss
dysphasia
bleeding
recurrent vomiting
lifestyle advice for dyspepsia (4)
reduce alcohol and fat intake
weight reduction
raise head of the bed
smoking cessation
how long should a PPI be used in uninvestigated dysphasia
4 weeks
when should antacids be given?
when indegestion is expected - before meals and at night and prn
are liquid or tablet antacid preparations more effective?
liquid
what is the effect of ………………… on bowel transit time
Magnesium
Aluminium
Magnesium is laxative
Aluminium is constipating
bismuth containing preparations are no longer recommended for dyspepsia as they are
neurotoxic (unless chelates)
cause encephalopathy
constipating
calium containing antacids are not ideal because
they cause rebound acid secretion
hypercalcemia
alkalosis
precipitate the mil alkali reaction
what is the point in simeticone in antacids
antifoaming agent to releive flatulance
also used for hiccups in pallative care
alinginates work by
increase the stomach viscosity and protect the oesogeal mucosa from acid reflux
form a raft on top of stomach contents
why should you not use aluminium containing antacids in infants
accumulation of aluminium
