PAC3421 Lecture Notes - Lecture 24: Alendronic Acid, Aspirin, Doxycycline
26 Jun 2018
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GORD – gastro-oesophageal reflux disease
- Aka heartburn -> where reflux is the passage of stomach contents past lower oesophageal sphincter into
oesophagus -> can lead to mucosal damage
- Complications: deep ulceration, malignancy, tracheal aspiration (due to regurgitation)
Management:
- Antacids, antacid/ alginate
oAluminium / Mg hydroxide
Remember: Al (causes constipation), Mg salts (causes diarhhoea)
oNa+ salts -> need to take care in hypertension, cardiac, renal + liver diseases
oCa 2+ salts -> constipation/ diarrhoea
oSugar -> need to take care in diabetes
- Alginic acid – raft on surface
- Simethicone – anti flatulent
- Tablets are LESS effective than liquids
- H2R antagonists -> ranitidine, nizatidine
- Strongest: Proton pump inhibitors -> esomeprazole, omeprazole, pantoprazole (gen. well tolerated)
Goals of Tx:
- Relieve symptoms - If present, heal oesophagus
- ↓ risk of dev. Complications such as Barrett’s oesophagus
Other alarm symptoms:
- GIT bleeding - Weight loss more than 3kg - Progressive dysphagia (diff swallowing)
- Anaemia - Vomiting
- Failure to respond to drug treatment
Drug-induced oesophageal ulceration +/- stricture (closing of oesophagus)
- Tetracyclines eg. doxycycline
- Oral bisphosphates eg. alendronate
- NSAIDS eg. aspirin
- Ferrous sulphate
- Slow release KCL
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