GERD & PUD

Question 1

What drugs worsen GERD sx

Answer 1

ASA/NSAIDs
fish oils
bisphosphonates
iron supplements
NRT
steroids
TTC
dabigatran

Question 2

patient who experiences GERD sx about once a week.
tx recommendation?

Answer 2

<2x/week so can do OTC antacids or H2RA

Question 3

what are the criteria for a patient to receive 8 week PPI instead of OTC antacids or H2RA

Answer 3

2+ incidences of HB a week

Question 4

Ca carbonate brand

Answer 4

Tums

Question 5

Ca carbonate + mag hydroxide

Answer 5

Mylanta

Question 6

mag hydroxide brand

Answer 6

MOM

Question 7

ca carbonate + simethicone

Answer 7

Maalox

Question 8

Al + mag hydroxide + simethicone

Answer 8

Mylanta max strength

Question 9

what are the components of Alka Seltzer

Answer 9

ASA
sodium bicarb
citric acid

Question 10

Al and Ca products are CI in _____. why?

Answer 10

CI in CrCl <30 due to renal deposits

Question 11

what is the preferred treatment for acid reflux in pregnancy

Answer 11

ca carbonate (tums)

Question 12

how long do antacids typically last

Answer 12

30-60 min

Question 13

how do antacids work

Answer 13

produce salt and water to increase gastric pH

Question 14

famotidine
brand name
dosing

Answer 14

Pepcid
OTC: 10-20mg PO QD-BID PRN
Rx: 20mg PO BID
de dose if CrCl <60 2/2 ECG changes with renal dysfunction

Question 15

famotidine (Pepcid) comes in combinations with

Answer 15

mag hydroxide (Pepcid complete)
ibuprofen (Duexis)

Question 16

when should famotidine be taken

Answer 16

30-60 min before a meal

Question 17

adverse effects of famotidine

Answer 17

ECG changes in renal dysfunction
psych SE
B12 deficiency
HA

Question 18

H2RAs are reversible or irreversible?

Answer 18

reversible

Question 19

cimetidine dosing

Answer 19

OTC: 200mg 1-2x/day PRN
Rx: 400mg PO Q6H

Question 20

SE of all H2RAs

Answer 20

HA
B12 deficiency

Question 21

what H2RA was pulled of the market in April of 2020

Answer 21

ranitidine

Question 22

dexlansoprazole
brand
OTC, Rx or both?
dosing

Answer 22

Dexilant
Rx only
30-60mg PO QD without regard to meals

Question 23

pantoprazole
brand
OTC, Rx or both?
dosing

Answer 23

Protonix
Rx only
40mg PO QD

Question 24

what PPIs are available IV

Answer 24

pantoprazole
esomeprazole

Question 25

adverse effects of pantoprazole IV

Answer 25

thrombophlebitis SJS/TEN

Question 26

omeprazole brand OTC, Rx or both? dosing

Answer 26

Prilosec Rx and OTC OTC: 20mg PO QD RX: 20-40mg PO QD

Question 27

pantoprazole and dexlansoprazole can be taken

Answer 27

without regard to meals

Question 28

omeprazole comes in which dosage forms SATA A. IV B. cap C. tab D. powder for suspension E. solution F. ODT

Answer 28

B. cap C. tab D. powder for suspension F. ODT

Question 29

esomeprazole brand OTC, Rx or both? dosing

Answer 29

Nexium OTC and Rx OTC: 20mg PO QD Rx: 20-40mg PO QD

Question 30

lansoprazole brand OTC, Rx or both? dosing

Answer 30

Prevacid OTC and Rx OTC: 15mg PO QD Rx: 15-30mg PO QD

Question 31

which PPIs come in a packet for suspension

Answer 31

opemrazole (Prilosec) esomeprazole (Nexium) pantoprazole (Protonix)

Question 32

which PPIs come in ODT form

Answer 32

omeprazole (Prilosec) lansoprazole (Prevacid)

Question 33

warnings for all PPIs

Answer 33

c. diff diarrhea B2 deficiency when used 2+ years OP related fractures if high dose or 1+ years hypomagnesemia AIN SJS/TEN DO NOT USE X>8 WEEKS IN ELDERLY

Question 34

DDI between esomeprazole and omeprazole with plavix

Answer 34

omeprazole and esomeprazole inhibit 2C19 which activates plavix and they therefore decrease plavix efficacy

Question 35

what drugs need an acidic gut and therefore interact with antacids, H2RAs and PPIs

Answer 35

rilpivirine (NNRTI), atazanavir (PI) -azoles cefpodoxime and cefuroxime (po cephalos) iron products mesalamine rsendronate DR TK-is (-nibs)

Question 36

what drugs bind antacids

Answer 36

INSTIs levothyroxine bisphosphonates isoniazid MMF FQs sotalol TTCs steroids

Question 37

first line treatment for h, pylori PUD

Answer 37

BSS quad therapy BSS 300mg PO QID + metronidazole 250-500mg PO QID + tetracycline 500mg QID + PPI BID all x14 days

Question 38

counseling points for BSS Quad therapy for h pylori

Answer 38

no pregnancy no alcohol not for <8 yo

Question 39

when are clarithromycin-containing h pylori regimens appropriate

Answer 39

if resistance is <15% AND the patient has never ever received a macrolide in their life for any reason

Question 40

risk factors for NSAID-induced ulcers

Answer 40

>60 yo high dose NSAIDs use with ASA use with anticoagulants, steroids, SSRI, SNRI use of >1 NSAID hx of any PUD

Question 41

NSAID-induced PUD tx

Answer 41

PPI x8 weeks

Question 42

alternatives to PPI treatment for NSAID-induced PUD

Answer 42

hgh dose H2RA or sucralfate

Question 43

sucralfate dosing

Answer 43

1g PO QID before meals