heartburn and dyspepsia Flashcards
(46 cards)
heartburn definition
burning sensation arising from substernal area and moves up toward neck/throat/potentially back
episodic heartburn
less than two days per week, mild and infrequent
frequent heartburn
more than or equal to 2 days per week
dyspepsia
‘bad digestion’, consistent or recurrent discomfort with on or more of the following: epigastric pain, burning, postprandial fullness, and early satiety. discomfort is usually located in upper abdomen
GERD
a condition which develops when the reflux of stomach contents causes troublesome symptoms and/or complications
factors that contribute to heartburn
dietary, lifestyle, disease, meds, genetic factors, and pregnancy
dietary examples that cause heartburn
alcohol, caffeine, carbonated beverages, chocolate, citrus, fruit, juices, fatty or greasy foods, garlic, onions, mint, salt, spicy foods, tomatoes
lifestyle examples that cause heartburn
exercise, obesity, smoking, stress, supine body position, tight fitting clothes
disease examples that cause heartburn
motility diseases, PUD, scleroderma, Zollinger-Ellison syndrome
exclusions for self care
- frequent heartburn for more than 3 months
- heartburn while taking recommended dosages of nonRX H2RA or PPI
- heartburn that continues after 2 weeks of treatment
- heartburn and dyspepsia that occur during treatment
- severe heartburn or dyspepsia
- nocturnal heartburn
- difficulty or pain swallowing food
- vomiting blood or black material or tarry stools
- chronic hoarseness, wheezing, coughing, or choking
- unexplained weight loss
- continuous n/v/d
- chest pain
- adults > 45 years with new onset dyspepsia
non pharm treatment
eating smaller meals, reduce intake of dietary fat, refrain from lying down within 3 hours after meal, losing weight, stopping or reducing smoking, wearing loose-fitting clothing, avoid alcohol, tobacco, or caffeine, drink water and chew gum, elevate head of bed
antacid MOA
neutralize gastric acid, may increase LES pressure
administration antacid
every 1-2 hours as needed but should not exceed max daily dose
advantages of antacid
least expensive, rapid onset
antacids containing magnesium
may cause diarrhea
antacids containing aluminum or calcium
may cause constipation
onset/duration for antacids
rapid onset of symptom relief (< 5 min); short duration of action when taken on an empty stomach (20-30 min); duration of relief may be prolonged for several hours by taking after meal
drug interactions with antacids
can usually be avoided if administered at least 2 hours apart
antacids can be combined with
H2RA for better symptom relief
BSS should not be used in
children ( < 16 years), pregnancy, breast feeding, or those with an increased bleeding risk
H2RA MOA
blocks H2 receptors to decrease gastric acid secretion which decreases the volume of secreted acid
compared to antacids, H2RAs
do not relieve heartburn or dyspepsia as rapidly, but have a longer duration of action
onset/duration of H2RA
onset averages 30-45 min and duration is 4-10 hours
dosing of h2ra
should be limited to no more than twice daily
