Question

. Investigate and report the evidence related to the nonpharmacological management of gastroesophageal reflux disease (GERD).

What recommendations would you make to your potential client?

2. Compare and contrast the differences between the H2 receptor antagonists, PPIs, and antacids.

3. Sam has been taking bismuth subsalicylate (Pepto-Bismol®) for diarrhea and is alarmed because his stools have turned black. What would you say to Sam and what recommendations would you suggest?

4. Discuss nonpharmacological treatments of nausea and vomiting. Include in this discussion the use of marijuana as a treatment.

Answer 1

1) Nonpharmacological management of gastroesphageal reflux disease(GERD): a)aviod or reduce smoking, b) avoid foods and beverages associated with an increase in heartburn symptoms, c) large meals are avoided, d)refrain from eating 2-3 hours prior to going to bed or lying down, e) wear loose fitting clothing, f)loose weight if obese, g) head end bed elevation, h) avoidance of precipitation factors.The investigate and report the evidence related to the nonpharmacological managment of GERD shows that the patient reported benefits including underrstanding relevant anatomy and physiology , and learning behavioural techniques to change eating patterns and manage stress and lifestyle change shows improvement in the patient of GERD. 2)These 3 classes of drugs are medications of gastroesophageal reflux disease are H2 blockers , and Antacids and proton pumpinhibitors(ppi), the compare and contrast the difference between these 3 are a)onset of action: the H2 blockers acts within 1 hour and PPI take up to 4 days to take effect, and antaids acts within 5 minutes , b)duration of action : H2 blockers action lasts about 9 to 12 hours, and PPI lasts 24hrs upto 3 days, antacids actions lasts upto 30 to 60 minutes,c) end result of action the H2 blockers suppress gastric secretion and PPI action is to suppressgastric acid secretion and antacids action is neutralizes acid instomach.d)mechanism of action: H2 blockers block histamine and PPI blocks the proton pump that pumps proton into the stomach in exchange for potassium , h+ is acid,e) where they work : H2 Blockers work inside the perietal cells and PPI works inside the parietal cells and antacids works instomach lumen, etc. 3)On taking the pepto bismol for diarrhea and is alarmed because the stools have truned black, i would tell sam that discoloration is temporary and harmless and the black color stool because of the active ingredient that is bismuth , when the small amount of bismuth combines with traces amounts of sulfur in the saliva and gastroinstential tract a black substances is formed ( bismuth sulfide) , and it lasts several days after the stop of this medication. 4) Nonpharmacological treatment of nausea and vomiting: a)cool damp cloth to forehead, neck, wrists, b) bland , cool or room temperature foods , c) deccrease noxious stimuli , d) limit fluids with food, e) freshair, fan, f) relaxation techniques, g) oral care after each emesis, the use of marijuana in the tratment of nausea and vomiting beacuse the marijuana contains delta 9 tetrahydrocannabinol which binds with the endocannabinoid receptors in the brain and causes relief or relaxation of the nauseating tendencies.