GERD and PUD

Question 1

Drugs that worsen GERD

Answer 1

ASA/NSAIDs, bisphosphonates, dabigatran, estrogen, fish oil, iron, nicotine, steroids, tetracyclines

Question 2

Referal to MD for GERD

Answer 2

non-response after 2 weeks of OTC, alarm symptoms

Question 3

Alarm symptoms of GERD

Answer 3

dysphagia, n/v, hematemesis, bloody stools, unintentional weight loss

Question 4

concern with antacids in low GFR

Answer 4

Aluminum and magnesium buildup

Question 5

SE of aluminum, calcium, and magnesium

Answer 5

Aluminum and calcium cause constipation while magnesium causes loose stools

Question 6

Preferred antacid in pregnancy

Answer 6

Calcium

Question 7

Why is cimetadine avoided?

Answer 7

drug interactions and SE, including gynecomastia and impotence at high doses

Question 8

Recommended PPI treatment duration

Answer 8

8 weeks

Question 9

Timing PPI administration

Answer 9

Before breakfast. Esomeprazole at least 60 minutes before. Dexlansoprazole can be taken without regard to meals

Question 10

Warnings for PPI

Answer 10

C. Diff, hypo magnesium, B12 deficiency osteoperosis related fractures

Question 11

PPI and Clopidogrel

Answer 11

Do not use esomeprazole or omeprazole while taking clopidogrel due to diminished effect of clopidogrel

Question 12

IV PPIs

Answer 12

Esomeprazole and Pantoprazole

Question 13

ODT PPI

Answer 13

Lansoprazole, Omeprazole

Question 14

PPI for suspension

Answer 14

Lansoprazole, esomeprazole, omeprazole, pantoprazole

Question 15

Metoclopramide uses in GERD

Answer 15

used with erythromycin in patients with gastroparesis

Question 16

BBW metoclopramide

Answer 16

Tardative dyskenisia. Avoid in Parkinson’s patients

Question 17

Drugs that like an acidic gut

Answer 17

Antiretrovirals, antivirals, azoles, cephalosporins, iron, mesalamine, risedronate, TKis