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indications for PPIs?
- GORD
- Dyspepsia
- GI treatment/prevention from NSAIDs
- Zollinger-ellison syndrom
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Precautions of PPIs
Gastric carcinoma, exclude condition before starting treatment
Pregnancy - use ranitiine if possible othewise omeprazole is safe
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Adverse effects of PPIS
headache, nausea, vomiting, diarrhoea
Rash, itch, decreased absorption of vitamin B12 (over time)
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Dose of omeprazole?
20mg once daily for 4-8 weeks - PUD & GORD
prevention of a GI ulcer - 20mg daily
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Dose for Lansoprazole?
30mg once daily for 4-8 weeks -GORD,PUD
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Dose of esomeprazole?
20mg once daily - PUD/GORD
Prevention - 20mg daily
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Dose of Pantoprazole?
40mg once daily for 4-8 weeks
GORD - 40mg 4-8 weeks, then increase to 40mg bd for the next 4 weeks
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Dose of rabeprazole?
20mg once daily for 4-8 weeks - GORD & PUD
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Counselling for PPIs?
Swallow whole, do not crush or chew tablet
Review maintaince therapy regularly
Tell your doctor if you develop black stools or coffee ground coloured vomit
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Association between PPIS and pneumonia?
Increased incidence
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What supplements may be required in long term use with PPIs?
Calcium and vitamin D - due to increased fracture risk
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Indications for ranitidine?
- Peptic ulcer disease
- GORD
- Dyspepsia
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Advderse effects of ranitidine?
usually very well tolerared
may get hypotension - rare.
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Dose of ranitidine?
150mg twice daily for dyspepsia
300mg daily for PUD
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