Deepak's Last Week Stuff

Goal of Treatment
 Bring the symptoms under control.
 Heal the esophagus.
 Manage or prevent complications.
 Maintain the symptoms of GERD in remission.
1st Line: Changes to Lifestyle
 Position
 Eating Manner
 Diet
 Weight Loss
 Smoking Cessation
 Simple Antacids (over-the-counter)
 Avoiding NSAIDS

2nd Line: Medical Intervention
CLASS MOA EXAMPLES DOSAGE
Alginate –containing Antacids Neutralise stomach acid,
forms foam raft. Ca, Mg, Al containing antacids As and when necessary (after meals)
H2 Antagonists Acid supression cimetidine, ranitidine, famotidine 30 minutes before meals
Proton Pump Inhibitors Reduce gastic acid production by up to 90% omeprazole, rabeprazole, lansoprazole, pantoprazole, esomeprazole Severe:
Twice daily & prolonged for years
Pro-Motility Drugs Stimulate muscles of GIT metoclopramide 30 minutes before meals,
at bedtime
3rd Line: Surgical Intervention
The operation used most often for GERD is called fundoplication. The top of the stomach is wrapped around the lower end of the oesophagus, tightening the oesophageal sphincter.
http://www.youtube.com/watch?v=9bnIuKiHdDE

By Deepak