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Pharmacology- Too many enchiladas
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- 1What are 3 rationales for treatment of GORD1. Symptom relief and control
2. Heal oesophagitis
3. Reduce risk of complications - 2What on demand medications are recommended to treat GORD and what is their mode of action? Identify 2.Antacid
MOA: Neutralise the excessive gastric acid, raise pH and provide rapid relief
or
Antacid + alginate
MOA: + form a thick layer (raft) on top of the stomach contents once it makes contact with gastric acid stopping reflux - 3What medications are recommended for GORD when firstline symptom relief is not effective? Name the Class and drugs.1. H2 Receptor antagonist (blocker) -
Cimetidine, Famotidine, Nizatidine, Ranitidine
2. PPIs -
Omeprazole, Lansoprazole, Pantoprazole - 4What is the class and MOA for: Lansoprazole Omeprazole PantoprazoleCLASS: PPI
MOA: Bind irreversibly to H/K ATPase and inhibit the protein pump, producing long lasting suppression of gastric acid secretion.
Act irrespective of stimulus as do not act on receptors. - 5What is the class and MOA for: Cimetidine, Famotidine, Nizatidine and RanitidineClass: H2 receptor antagonist
MOA: Competitively antagonist of histamine H2 receptor, inhibiting the action of the H2 receptor at the parietal cell reducing secretion of gastric acid - 6Protein pump inhibitor Adverse EffectsHeadache, n&v, diarrhoea, abdo pain, constipation, flatulence
Long term: osteoporosis, VB12 deficiency - 7Lifestyle changes for GORD1. Reduce alcohol intake and cease smoking
2. Weight loss
3. Raising bed head
4. Avoid trigger foods: caffeine, chocolate, fatty or spicy
5. Smaller meals - 8Which Gord medication is preferred in pregnancy?H2 receptor antagonist: Ranitidine
- 9Which medications can worsen reflux1. NSAIDs
2. CCBs
3. Nitrates - 10How long should PPIs be taken before reveiw2 weeks then referral to see a GP if symptoms persist
- 11Risk factors for Peptic Ulcer Disease1. H. pylori
2. long term NSAID use - 12How is H. pylori treated?Triple treatment
PPI + 2 antibiotics
1. Omeprazole, amoxicillin, clarithromycin or;
2. Omeprazole, clarithromycin and metronidazole
Clarithromycin inhibits CYP3A4 leading to enhanced PPI activity
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- Beschreibung
- Nursing Pharmacology - GORD/Dyspepsia/PUD
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- P B
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- 34
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