Flashcards in GERD Deck (23)
___ is a condition or histiological alteration resulting in reflux.
___ ___ is inflammation of esophagus secondary to reflux.
What are the 4 aggressive factors in GERD?
acid, pepsin, bile acids, and pancreatic enzymes
What is the hallmark sign of GERD?
Heartburn can be aggravated by ___.
Other signs of GERD besides heartburn include:
regurgitation, dysphagia, bleeding, chest pain
Aims of tx for GERD include: increase ___ pressure, improve ___ emptying, decrease ___ and ___.
LES, gastric, acidity, volume
Phase 1 tx for GERD includes:
elevate bed, change diet, stop smoking, avoid certain meds, antacids or gaviscon, OTC H2's
Phase 2a tx for GERD includes:
H2's, prokinetic agents, bethanechol, sucralfate
Phase 2b tx for GERD includes:
Hi-dose H2's, PPI
Phase 3 tx for GERD includes:
antireflux laparoscopic surgery (Nissen fundoplication)
Alginic Acid (aka ___) is an antacid that ___ acid and creates a ___ that floats on top of ___ secretions to provide a mucosal barrier on the ___.
Gaviscon, neutralizes, foam, acid, esophagus
___ are the mainstay therapy for GERD. Superior to ___.
With GERD, you want continuous acid ___.
Bethanechol is a ___ agent that increases ___ tone for GERD. Do not want to use in ___, ___ or ___.
cholinergic, LES, PUD, astha, COPD (b/c you use anticholinergics to tx COPD)
___ is a prokinetic agent that increases ___ tone and gastric ___. Is a ___ antagonist, so don't give to pt's w/___.
Metoclopramide, LES, emptying, dopamine, PD
Metoclopramide has extrapyramidal s/e, including ___ ___ and ___.
tardive dyskinesia, dystonia's
Tx for mild GERD:
lifestyle changes, antacid or low dose H2
H2-RA's or PPI
PPI is best option
May have to switch to ___ if higher doses of H2's not effective.
Tx for GERD is ___, whereas it is short-term therapy for ___.
Dosing for GERD is ___, whereas it can be ___ for PUD.
Acetylcholine stimulates ___ production, so do not want to give ___ in PUD, only for use in GERD.