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Risk factors for GERD
- Being overweight
- Being pregnant
- Certain diseases (e.g. diabetes, asthma, peptic ulcers)
- Certain drugs (e.g. nonsteroidal anti-inflammatory drugs)
- Drinking alcohol and caffeinated beverages
- Eating foods with high acid content (e.g. tomatoes, orange juice)
- Eating fatty and spicy foods
- Lying down too soon after meals
How does famotidine (Pepcid) work?
Famotidine is a histamine H2 blocker that causes decreased stimulation of H2 receptors in gastric cells that secrete hydrochloric acid leading to a decrease in gastric acid secretion.
What are the adverse effects of famotidine?
- Abnormal heart rhythms
- decreased white blood cell count
What to teach patients taking famotidine?
- Notify prescriber if taking OTC H2 blockers for more than 2 weeks and still experiencing reflux.
- Do not smoke; smoking interferes with action of these drugs.
What are the most powerful drugs used for treating PUD or GERD?
Proton Pump Inhibitors [rabeprazole (AcipHex)]; should be used only for a limited time.
Why should rabeprazole only be used for limited time?
- PPIs may lead to stomach infections because inhibition of stomach acid that help kill bacteria.
- May lead to anemia because loss of stomach acid reduces digestion of protein.
When should PPIs be given?
PPIs should be given before meals, preferable in the morning.
When taking aluminum hydroxide (Amphojel) with other drugs, when should they be taken?
Patients should not take an aluminum hydroxide or a calcium carbonate antacid within 1 or 2 hours of taking other drugs.
Why is sucralfate (Carafate) prescribed?
Sucralfate is prescribed to protect open-sore areas in the GI tract and allow ulcers to heal.
What are the six types of generalized seizures?
Generalized seizures affect most or all of the brain and are divided into six types: tonic-clonic, tonic, clonic, absence, myoclonic, and atonic.
What is a tonic-clonic (grand mal) seizure?
Tonic-clonic (or grand mal) seizures last 2 to 5 minutes with stiffening or rigidity of the arm and leg muscles and immediate loss of consciousness.
What is a tonic seizure?
Tonic seizures include sudden increase in muscle tone, loss of consciousness, and loss of autonomic signs for 30 seconds to several minutes.
What is a clonic seizure?
- Clonic seizures are characterized by muscle contraction and relaxation.
- [G. klonos, a tumult]
What is an absence (or petit mal) seizure?
Absence (or petit mal) seizures are more common in children and tend to occur in families. They last a few seconds with loss of consciousness and blank staring like daydreaming.
What is a myoclonic seizure?
A myoclonic seizure involves brief asymmetric or symmetric jerking or stiffening of the extremities that lasts a few seconds.
What is an atonic seizure?
An atonic seizure typically has sudden loss of muscle tone for a few seconds, followed by postictal (after the seizure) confusion.
What is a simple partial seizure?
With a simple partial seizure the patient remains conscious and may report an aura. It typically includes one-sided movement of an extremity, unusual sensations, or autonomic changes such as heart rate, flushing, or epigastric discomfort.
What is a complex partial seizure?
Complex partial seizures cause patients to lose consciousness for 1 to 3 minutes. Patients may have automatisms such as lip smacking, patting, or picking at clothes, typically followed by amnesia.
What is status epilepticus?
Status epilepticus is a seizure lasting longer than 30 minutes or a series of any type of repeated seizure. Rapid recognition and treatment of this disorder is essential in preventing brain damage, coma, and death.
What is the action of first-line drugs for partial and generalized seizures?
First-line drugs for partial and generalized seizures act on the brain and nervous system to cause a decrease in the voltage, frequency, and spread of electrical impulses within the motor cortex of the brain.
List two first-line drugs for partial and generalized seizures:
- carbamazepine (Tegretol)
- phenytoin (Dilantin)
What is an adverse effect of phenytoin?
Phenytoin can lead to Stevens-Johnson syndrome.
What should clients taking carbamazepine (Tegretol) avoid consuming?
Clients taking carbamazepine (Tegretol) should avoid grapefruit and grapefruit juice because they increase the effects of this drug.
Name a first-line drug for absence seizure:
What should a client taking ethosuximide (Zarontin) be taught to wear out-of-doors?
Ethosuximide (Zarontin) makes eyes more sensitive to light, therefore should protect eyes with dark glasses in bright light.
Name a second-line drug for seizures:
What is an adverse effect of clonazepam?
Clonazepam is a benzodiazepine CNS drug with the life-threatening adverse reaction of respiratory depression.
Which anti-seizure drugs can increase the effects of anticoagulant drugs?
- Valproic acid