PC707 Mod 3A: GI- Peptic Ulcers and GE Reflux Questions and Answers 100% Correct.

Antacids - ANSWER-First line treatment for dyspepsia Diarrhea & constipation - ANSWER-Most common side effects of antacids Effect of anti-acids on enteric-coated medications - ANSWER-Antacids decrease the stomach pH causing the stomach to be more Alkaline like the small intestines. Enteric coated medications are made to be absorbed in more alkaline environment Examples of antacids - ANSWER-Calcium carbonate, sodium bicarbonate, milk of magnesia, aluminum salt, aluminum hydroxide Calcium carbonate - ANSWER-Tums/Rolaids; Cause constipation Sodium bicarbonate - ANSWER-Alka-Seltzer; cause hypertension and contain aspirin; contraindicated in pregnancy Milk of magnesia - ANSWER-Cause diarrhea and Contraindicated In renal insufficiency Aluminum salts - ANSWER-Amphogel; Causes Constipation and contraindicated in renal insufficiency Aluminum hydroxide - ANSWER-May decrease the absorption of Coumadin H2 receptor antagonist - ANSWER-First line treatment for Gerd, Binds to histamine receptors cells to decrease the production of acid H2 receptor antagonist examples - ANSWER-Zantac/ranitidine; Pepcid/Famotidine, cimetidine/Tagamet cimetidine/tagamet - ANSWER-H2 antagonist, Should be avoided due to drug to drug interactions, interferes with Coumadin, contraindicated in pregnancy Proton pump inhibitor's - ANSWER-Second line treatment for Gerd How PPIs work - ANSWER-Decreases the production of acid quick, can decrease absorption of iron calcium and B12 they are linked to osteoporosis and stomach cancer and increased thickening of the stomach lining Prostaglandin analog's - ANSWER-Increased mucus production to protect the stomach lining, Often prescribed with NSAIDS, contraindicated in pregnancy, but can be used off label for induction G.I. cocktail - ANSWER-Rule out cardiac events before prescribing Weight loss and elevating HOB - ANSWER-Lifestyle changes that may help with Gerd Consider when prescribing PPIs - ANSWER-Does the patient still need them? Why was the patient taking them? Is the patient taking long term NSAIDS? Does the patient have a proper diagnosis for long-term treatment and does the benefits outweigh the risks? Deprescribing - ANSWER-Discontinuing medications patients no longer need treatment for 4 to 8 - ANSWER-PPI treatment for ulcers should be __to___weeks. Long-term use of PPIs - ANSWER-Osteoporosis, bone fractures, community acquired pneumonia, cdiff, Kidney disease, decreased calcium and magnesium Tapering PPIs - ANSWER-Discontinue over 2 to 4 weeks to prevent rebound Hyperacidity H pylori - ANSWER-Gram-negative bacillus, most common cause of PUD Treatment goals of PUD - ANSWER-Symptom relief, healing of gastric and duodenal mucosa & prevention of Complications and reoccurrence PUD Drug regimen - ANSWER-Triple or quadruple all therapy due to antibiotic resistance; Cost, multi drug regimen, lack of Compliance and tolerance PBMT - ANSWER-PPI, Bismuth, Metronidazole, Tetracycline PAMC - ANSWER-PPI, Amoxicillin, Metronidazole, Clarithromycin PAC - ANSWER-PPI, Amoxicillin, Clarithromycin PMC - ANSWER-PPI, Amoxicillin, Clarithromycin PAM - ANSWER-PPI, Amoxicillin, Metronidazole Pregnancy category B antacid - ANSWER-Milk of mag (1st line) Pregnancy category C antacid - ANSWER-TUMS, Rolaids, simethicone, Contraindicated in pregnancy - ANSWER-Bismuth Subsalicylate/ Pepto-Bismol, Sodium bicarbonate antacids Pregnancy Category B H2 Antagonist - ANSWER-Tagamet, Pepcid, axid, Zantac, reglan Pregnancy category B PPIs - ANSWER-All of PPIs except Prilosec Pregnancy category C PPIs - ANSWER-Omeprazole/ Prilosec Cyto