Chapter 13: Heartburn and Dyspepsia Flashcards

(45 cards)

1
Q

what is the medical term for heartburn?

A

pyrosis

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2
Q

heartburn is the main symptom of what disease?

A

gastroesophageal reflux disease (GERD)

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3
Q

what does dyspepsia mean?

A

discomfort or pain that occurs in the upper abdomen

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4
Q

dietary factors that may contribute to heartburn and GERD?

A
alcohol
caffeine
chocolate
citrus
fatty foods
spicy foods
sugar
mint
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5
Q

lifestyle factors that may contribute to heartburn and GERD?

A

obesity
smoking
stress

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6
Q

heartburn symptoms occurring two+ times a week are suggestive of?

A

GERD

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7
Q

what are some “alarm symptoms” of heartburn?

A
dysphagia (difficulty swallowing)
odynophagia (painful swallowing)
vomiting
GI bleed
unexplained weight loss
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8
Q

what is dysphagia?

A

difficulty swallowing

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9
Q

what is odynophagia?

A

painful swallowing

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10
Q

what is PUD?

A

peptic ulcer disease

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11
Q

what is a good recommendation for a pt for rapid relief of symptoms of heartburn?

A

antacids

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12
Q

what is a good recommendation for longer-lasting symptom relief of infrequent heartburn or dyspepsia?

A

histamine type 2 receptor antagonists (H2RAs)

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13
Q

patient should not exceed __ days of self-treatment with an antacid or H2RA w/o consulting PCP

A

14

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14
Q

what’s a good recommendation for treating frequent heartburn (2 or more x/wk) and is taken daily?

A

proton pump inhibitors (PPIs)

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15
Q

patient should not exceed __ days of self-treatment with a PPI and should not use again for __ months

A

14, 4

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16
Q

what is a lifestyle modification to recommend a pt w/ heartburn or dyspepsia who is overweight?

A

weight loss

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17
Q

what is a GERD pillow?

A

foam wedge placed beneath torso and head to decrease symptoms at night

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18
Q

if pt is experiencing mild, infrequent heartburn, what is the recommendation?
if pt sees no improvement, what else can they do?

A

lifestyle/dietary changes and-
antacid, low-dose H2RA, or combination of the two

use a PPI or see Dr

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19
Q

if pt is experiencing moderate, infrequent heartburn, what is the recommendation?
if pt sees no improvement, what else can they do?

A

lifestyle/dietary changes and-
antacid or high-dose H2RA

use a PPI or see Dr

20
Q

if pt is experiencing heartburn 2 or more times a week, what is the recommendation?

A

lifestyle/dietary changes and-

PPI daily for 14 days or H2RA as needed

21
Q

what are the exclusions for self-treatment of heartburn?

A
  • HB lasting more than 3 months
  • HB while taking correct dosing of H2RA/PPI
  • HB continuing after 2 weeks w/ H2RA/PPI
  • HB occurring when taking H2RA/PPI
  • Severe HB or dyspepsia
  • HB at night
  • Difficulty/pain swallowing solid foods
  • vomiting blood or black material
  • unexplained weight loss
  • wheezing, coughing, choking
  • continuous nausea, vomiting, or diarrhea
  • chest pain with sweating, shortness of breath
  • adults over 45 with new-onset dyspepsia
22
Q

how quickly do antacids work?

duration of relief?

A

less than 5 minutes

20-30 minutes

23
Q

how quickly do H2RAs work?

duration of relief?

A

30-45 min

4-10 hours

24
Q

how quickly do H2RA + antacid work?

duration of relief?

A

less than 5 minutes

8-10 hours

25
how quickly do PPIs work? | duration of relief?
1-3 hours | 12-24 hours
26
what's a good diet for lowering risk of GERD? what should pts do to keep track of/determine foods, beverages, and activities that correlate w/ symptom onset and severity?
Mediterranean diet | Symptom diary
27
how do antacids work in the stomach?
antacids contain basic ingredients to react with stomach acid to make the stomach less acidic
28
what are the adverse effects of antacids?
nausea bloating or gas, but usually well-tolerated
29
what are common side effects of antacids containing calcium carbonate and sodium bicarbonate?
belching and flatulence
30
antacid-asprin combination products should not be used for patients with risks of?
bleeding risks or salicylate sensitivities
31
what other acid can be taken with an antacid to provide better symptomatic relief than just antacid alone?
Alginic acid
32
what are the primary ingredient(s) found in pepto-bismol ultra liquid? what is dosage? max per day?
bismuth subsalicylate 15 mL q30min prn 8 doses (120 mL)
33
what are the primary ingredient(s) found in pepto-bismol chewable tablets? what is dosage? max per day?
bismuth subsalicylate chew or dissolve 2 tabs every 30-60min prn 16 tabs
34
what are the primary ingredient(s) found in tums extra strength tablets? what is dosage? max per day?
calcium carb chew 2-4 tabs prn 10 tabs
35
how to take cimetidine? | max per day?
1 tab w/ glass of water | 2 tabs
36
how to take famotidine? | max per day?
1 tab w/ glass of water | 2 tabs
37
how to take omeprazole? | max per day?
1 tab w/ glass of water 30 min before morning meal for 14 days 1 tab
38
how to take lansoprazole? | max per day?
1 cap w/ glass of water 30 min before morning meal for 14 days 1 cap
39
how to take esomeprazole? | max per day?
1 cap w/ glass of water 30 min before morning meal for 14 days 1 cap
40
what are the adverse effects of H2RAs?
none, they are usually well-tolerated
41
common side effects of H2RAs?
headache, diarrhea, constipation, dizziness, and drowsiness
42
adverse effects with short-term use of PPIs are?
uncommon
43
what are the names of all the antacids?
sodium bicarb. calcium carb magnesium hydrox. aluminum hydrox.
44
what are the names of all the H2RAs?
cimetidine | famotidine
45
what are the names of all the PPIs?
omeprazole esomepreazole lansoprazole