Question

Discuss medications to treat GERD. What specifically should patients be taught about these medications to prevent adverse side effects?

Answer 1

ANSWER- Medications to treat GERD-

• Antacids- medicines that neutralize the acid in the stomach. They contain ingredients magnesium , calcium, aluminium, sodium bicarbonate which is bases which neutralize the acid in the stomach.

example of antacid -milk of magnesia, aluminium hydroxide, sodium bicarbonate

• H2 receptor antagonist -histamin receptor antagonist acts with histamine at receptors on gastric parietal cells. They reduce acid secretion and pepsin production.

example of H2 receptor antagonist -cemitidine, ranitidine , famotidine

• proton pump inhibitor (PPI)- irreversibly blocking the hydrogen / potassium adenosine triphosphtase enzyme system of the gastric parietal cells.

example of PPI- omeprazole, pantoprazole, rabeprazole

• Prokinetic drugs- help to control acid reflux

example of prokinetic drugs - domperidone, metoclopramide

Patient eductaion-

• Avoid food that causes esophageal irritation like coffee, choclate, fatty food, peppermint, carbonated beverages, alcoholic drink, ciggrate smoking.
• Eat low fat and high fibre diet, remain upright for 2 hours after the meal.
• Avoid eating and drinking 2 hours before bed time and avoid wearing tifht clothes.
• Allivate the head of bed on 6-8 inches by blocks/ pillows.
• Avoid anticholenergics because it delay gastric emptying
• Avoid NSAIDS (i.e aspirin) because it can cause gastric ulcer.