GERD (Overview)
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Questions and Answers

Which structure separates the stomach from the esophagus?

  • Upper esophageal sphincter (UES)
  • Gastroesophageal junction (GEJ)
  • Pyloric sphincter
  • Lower esophageal sphincter (LES) (correct)

    • What happens when the lower esophageal sphincter (LES) fails to function properly?

  • The stomach contents flow back into the esophagus (correct)
  • The esophagus becomes narrower
  • The stomach produces excess acid
  • The LES becomes weaker

    • What can untreated GERD lead to?

  • Strictures in the esophagus (correct)
  • Increased LES pressure
  • Development of abnormal cell growth in the stomach
  • Erosion of the stomach lining

    • Which symptoms should prompt immediate medical attention?

    <p>Difficulty swallowing and chest pain</p> Signup and view all the answers

    When should individuals consult a primary care physician if over-the-counter products fail to provide relief?

    <p>After two weeks</p> Signup and view all the answers

    How frequently should individuals experience symptoms to indicate a GERD diagnosis?

    <p>Two or more times per week</p> Signup and view all the answers

    What is the potential consequence of untreated GERD?

    <p>Development of Barrett's esophagus</p> Signup and view all the answers

    What is odynophagia?

    <p>Pain while swallowing</p> Signup and view all the answers

    What is the main symptom of GERD?

    <p>Regurgitation</p> Signup and view all the answers

    What can persistent acid reflux result in?

    <p>Erosion of the esophagus lining</p> Signup and view all the answers

    Which lifestyle modification is NOT recommended for managing GERD?

    <p>Avoiding carbonated drinks</p> Signup and view all the answers

    What is the initial pharmacological treatment recommended if lifestyle modifications do not effectively manage GERD symptoms?

    <p>Proton pump inhibitors (PPIs)</p> Signup and view all the answers

    How long should proton pump inhibitors (PPIs) be taken initially for GERD treatment?

    <p>8 weeks</p> Signup and view all the answers

    What should be considered if symptoms persist after the initial eight-week treatment with PPIs?

    <p>Continuing with the same dose of PPIs</p> Signup and view all the answers

    Which medication is NOT recommended for the treatment of GERD?

    <p>Metoclopramide</p> Signup and view all the answers

    What is the recommended time interval for taking certain medications when also taking antacids, H2RAs, or PPIs?

    <p>2 hours before or after</p> Signup and view all the answers

    Which adverse effect is commonly associated with antacids?

    <p>Constipation</p> Signup and view all the answers

    Which combination product contains a mixture of magnesium and aluminum or calcium?

    <p>Mylanta Supreme</p> Signup and view all the answers

    Which medication should be used cautiously in individuals with impaired kidney function?

    <p>Phillip's Milk of Magnesia (MOM)</p> Signup and view all the answers

    Which medication should be avoided completely when taking antacids, H2RAs, or PPIs?

    <p>Erlotinib</p> Signup and view all the answers

    Which combination of medications in Alka-Seltzer may cause serious bleeding?

    <p>Sodium bicarbonate and aspirin</p> Signup and view all the answers

    Which class of medications commonly used for acid-related disorders reversibly inhibits H2 receptors?

    <p>Histamine-2 receptor antagonists (H2RAs)</p> Signup and view all the answers

    Which medication is NOT an example of a histamine-2 receptor antagonist (H2RA)?

    <p>Omeprazole (Prilosec)</p> Signup and view all the answers

    Which class of medications is the most effective for reducing gastric acid secretion?

    <p>Proton pump inhibitors (PPIs)</p> Signup and view all the answers

    Which adverse effect is NOT associated with histamine-2 receptor antagonists (H2RAs)?

    <p>Gynecomastia</p> Signup and view all the answers

    Which proton pump inhibitor (PPI) can be taken without regard to meals?

    <p>Dexlansoprazole (Dexilant)</p> Signup and view all the answers

    Which medication should be avoided altogether when using proton pump inhibitors (PPIs)?

    <p>Cimetidine (Tagamet)</p> Signup and view all the answers

    Which medication can control nocturnal symptoms if taken at bedtime?

    <p>Omeprazole + Sodium Bicarb (Zegerid)</p> Signup and view all the answers

    Which class of medications work by increasing gastric emptying?

    <p>Prokinetic dopamine antagonists</p> Signup and view all the answers

    What is the black box warning associated with long-term use of dopamine antagonists?

    <p>Tardive dyskinesia</p> Signup and view all the answers

    True or false: GERD is a condition that affects the stomach.

    <p>False</p> Signup and view all the answers

    True or false: Barrett's esophagus is a complication of untreated GERD.

    <p>True</p> Signup and view all the answers

    True or false: Individuals with GERD should consult a primary care physician if over-the-counter products fail to provide relief after two weeks.

    <p>True</p> Signup and view all the answers

    True or false: Alka-Seltzer contains a combination of sodium bicarbonate and aspirin?

    <p>True</p> Signup and view all the answers

    True or false: H2RAs generally have more long-term side effects compared to proton pump inhibitors (PPIs)?

    <p>False</p> Signup and view all the answers

    True or false: PPIs work by irreversibly inhibiting the H+/K+ ATPase pump, blocking acid production in the stomach?

    <p>True</p> Signup and view all the answers

    True or false: Prokinetic dopamine antagonists like metoclopramide increase gastric emptying and can cause drowsiness, restlessness, fatigue, hypertension, pro-arrhythmic effects, and diarrhea?

    <p>True</p> Signup and view all the answers

    True or false: Lifestyle modifications are the only treatment needed for managing GERD effectively.

    <p>False</p> Signup and view all the answers

    True or false: Antacids provide long-lasting relief and require systemic absorption.

    <p>False</p> Signup and view all the answers

    True or false: Proton pump inhibitors (PPIs) can be taken once daily for eight weeks and may be increased to twice daily if nocturnal symptoms persist.

    <p>True</p> Signup and view all the answers

    True or false: Drugs such as metoclopramide or sucralfate are recommended for the treatment of GERD.

    <p>False</p> Signup and view all the answers

    What are the potential adverse effects associated with histamine-2 receptor antagonists (H2RAs)?

    <p>Headache, vomiting in children under one year old, gynecomastia, impotence, increased serum creatinine levels</p> Signup and view all the answers

    What are the black box warnings associated with proton pump inhibitors (PPIs)?

    <p>Clostridium difficile-associated diarrhea (CDAD), osteoporosis-related fractures, hypomagnesemia, vitamin B12 deficiency, nephritis, systemic lupus erythematosus (SLE), gastrointestinal infections, pneumonia</p> Signup and view all the answers

    What are the potential adverse effects associated with dopamine antagonists?

    <p>Drowsiness, restlessness, fatigue, hypertension, pro-arrhythmic effects, diarrhea</p> Signup and view all the answers

    What are the potential adverse effects associated with metoclopramide?

    <p>Depression, EPS, acute dystonia, Parkinson-like symptoms, neuroleptic malignant syndrome (NMS)</p> Signup and view all the answers

    What are some lifestyle modifications that can help manage GERD effectively?

    <p>Weight loss, elevating the head of the bed, avoiding high-fat meals within two to three hours of bedtime, and steering clear of trigger foods and beverages such as caffeine, chocolate, acidic or spicy foods, and carbonated drinks.</p> Signup and view all the answers

    What is the initial pharmacological treatment recommended if lifestyle modifications do not effectively manage GERD symptoms?

    <p>Proton pump inhibitors (PPIs)</p> Signup and view all the answers

    What are the potential consequences of untreated GERD?

    <p>Untreated GERD can significantly affect an individual's well-being and quality of life.</p> Signup and view all the answers

    Which medications should be avoided completely when taking antacids, H2RAs, or PPIs?

    <p>Delavirdine, Dasatanib, Pazopanib, Erlotinib, Rilpivirine, Velpatasvir/Sofosbuvir (Epclusa), Risedronate (Altevia), Erlot</p> Signup and view all the answers

    Match the following symptoms with their potential association to GERD:

    <p>Pain while swallowing (odynophagia) = Alarm symptom that should prompt immediate medical attention Heartburn = Common symptom of GERD Hypersalivation = Symptom that can indicate GERD diagnosis Nausea/vomiting = Alarm symptom that should prompt immediate medical attention</p> Signup and view all the answers

    Match the following medications with their potential adverse effects:

    <p>Metoclopramide = Drowsiness, restlessness, fatigue, hypertension, pro-arrhythmic effects, and diarrhea Proton pump inhibitors (PPIs) = Black box warning associated with long-term use Dopamine antagonists = Increase gastric emptying and can cause drowsiness, restlessness, fatigue, hypertension, pro-arrhythmic effects, and diarrhea Antacids = Potential systemic absorption and long-lasting relief</p> Signup and view all the answers

    Match the following terms with their definitions:

    <p>Gastroesophageal reflux disease (GERD) = A common condition that affects millions of people worldwide, where the lower esophageal sphincter (LES) fails to function properly Barrett's esophagus = Abnormal cell growth in the esophagus, which can increase the risk of cancer Lower esophageal sphincter (LES) = A muscular ring that separates the stomach from the esophagus Epigastric pain = A symptom commonly associated with GERD</p> Signup and view all the answers

    Match the following medications with their associated adverse effects:

    <p>Cimetidine = Gynecomastia, impotence, and increased serum creatinine levels Famotidine = ECG/QT prolongation Ranitidine = ALTs elevation Metoclopramide = Tardive dyskinesia</p> Signup and view all the answers

    Match the following medications with their recommended time of administration:

    <p>Dexlansoparazole = Can be taken without regard to meals All other PPIs = 30-60 minutes before breakfast H2RAs = 30-60 minutes before a meal Metoclopramide = Four times daily before meals and at bedtime</p> Signup and view all the answers

    Match the following medications with their method of action:

    <p>H2RAs = Reversibly inhibiting H2 receptors, reducing acid secretion in the stomach PPIs = Irreversibly inhibiting the H+/K+ ATPase pump, blocking acid production in the stomach Antacids = Neutralizing excess stomach acid Metoclopramide = Increasing gastric emptying</p> Signup and view all the answers

    Match the following medications with their associated warnings or contraindications:

    <p>Metoclopramide = Use is generally avoided in patients with Parkinson's disease or those taking antipsychotic medications PPIs = Can interact with certain medications, such as clopidogrel, reducing its effectiveness H2RAs = Should be used with caution in individuals who are severely ill or have renal or hepatic impairment Cimetidine = Should be avoided altogether</p> Signup and view all the answers

    Match the following medications with their potential adverse effects:

    <p>Antacids = Unpleasant taste, constipation, bloating, belching, hypophosphatemia, and loose stools Proton Pump Inhibitors (PPIs) = Decreased absorption of certain medications, potential for long-term side effects Metoclopramide = Drowsiness, restlessness, fatigue, hypertension, pro-arrhythmic effects, and diarrhea Histamine-2 Receptor Antagonists (H2RAs) = No erosive symptoms, provide symptom relief</p> Signup and view all the answers

    Match the following medications with their recommended usage for GERD treatment:

    <p>Antacids = Quick relief, short duration, up to 4-6 times daily Proton Pump Inhibitors (PPIs) = Initial pharmacological treatment if symptoms persist after lifestyle modifications Histamine-2 Receptor Antagonists (H2RAs) = No erosive symptoms, provide symptom relief Metoclopramide or Sucralfate = Not recommended for the treatment of GERD</p> Signup and view all the answers

    Match the following medications with their potential drug interactions:

    <p>Antacids, H2RAs, or PPIs = Decreased absorption of certain medications Delavirdine, Dasatanib, Pazopanib, Erlotinib, Rilpivirine Velpatasvir/Sofosbuvir (Epclusa), Risedronate (Altevia), Erlot = Should be avoided completely when taking antacids, H2RAs, or PPIs Anti-Retrovirals Delavirdine Rilpivirine Atazanavir Dolutegravir Elvitegravir Raltegravir Iron Products FQ's Anti-Virals Ledipasvir Velpatasvir Sofosbuvir Bisphosphonates Mesalamine Sotalol Azoles Itra, Keto, Posa Isoniazid Risedronate DR Steroids + Thyroid products Cephalosporins Cefditoren Cefpodoxime Cefuroxime Mycophenolate Tyrosine Kinase inhibitors Tetracyclines = May have decreased absorption when taken with antacids, H2RAs, or PPIs</p> Signup and view all the answers

    Match the following medications with their potential adverse effects:

    <p>Antacids = Unpleasant taste, constipation, bloating, belching, hypophosphatemia, and loose stools Proton Pump Inhibitors (PPIs) = Decreased absorption of certain medications, potential for long-term side effects Metoclopramide = Drowsiness, restlessness, fatigue, hypertension, pro-arrhythmic effects, and diarrhea Histamine-2 Receptor Antagonists (H2RAs) = No erosive symptoms, provide symptom relief</p> Signup and view all the answers

    What is the role of the lower esophageal sphincter (LES) in preventing acid reflux?

    <p>The LES helps prevent acidic gastric contents from flowing back into the esophagus.</p> Signup and view all the answers

    What are some consequences of untreated GERD?

    <p>Untreated GERD can result in erosion, strictures, bleeding, and even the development of abnormal cell growth in the esophagus known as Barrett's esophagus, which can increase the risk of cancer.</p> Signup and view all the answers

    What are some alarm symptoms of GERD that require prompt medical attention?

    <p>Alarm symptoms of GERD include pain while swallowing (odynophagia), difficulty swallowing (dysphagia), nausea/vomiting, hematemesis (vomiting blood), black or bloody stools, or unexplained weight loss.</p> Signup and view all the answers

    What are the potential consequences of untreated GERD?

    <p>The potential consequences of untreated GERD include erosion, strictures, bleeding, and the development of abnormal cell growth in the esophagus known as Barrett's esophagus, which can increase the risk of cancer.</p> Signup and view all the answers

    What are the alarm symptoms that should prompt immediate medical attention?

    <p>The alarm symptoms that should prompt immediate medical attention include pain while swallowing (odynophagia), difficulty swallowing (dysphagia), nausea/vomiting, hematemesis (vomiting blood), black or bloody stools, or unexplained weight loss.</p> Signup and view all the answers

    What is the role of the lower esophageal sphincter (LES) in preventing acid reflux?

    <p>The lower esophageal sphincter (LES) is a muscular ring that separates the stomach from the esophagus. Its role is to prevent acidic gastric contents from flowing back into the esophagus.</p> Signup and view all the answers

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