If GI bleeding present H2 antagonists and proton pump inhibitors used for 2 to

If gi bleeding present h2 antagonists and proton pump

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If GI bleeding present: H2 antagonists and proton-pump inhibitors used for 2 to 3 months 4. Ranitidine, cemetidine, or famotidine – used for short term treatment of duodenal and gastric ulcers 5. Metoclopramide (Reglan) – increase LES pressure and promote movement of food through the stomach 6. Most common surgical procedure: a. Fundoplication – procedure that tightens the esophagus and suturing it into place 7. Other surgical devices: a. The Stretta system – uses electrodes to create tiny lesions on the LES. As the lesions heal, the tissue tightens, increasing the muscle mass of the LES and preventing reflux b. The Bard EndoCinch suturing system – creates small tucks in the LES with sutures to strengthen the muscle.
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15 c. The Eneryx implant – injects a solution in the LES. The liquid becomes spongy and reinforces the LES, preventing reflux. 8. DRUG THERAPY TABLE 45-2 Medications Used to Treat Problems in the Upper GI Tract (pg 659-660) - READ a. Antacids : neutralize gastric acid to relieve heartburn and sour stomach i. Ex: calcium carbonate (Tums), aluminum hydroxide (AlternaGel, Gaviscon), and aluminum hydroxide with magnesium hydroxide (Maalox, Mylanta) b. H2 Antagonists : suppress gastric acid by blocking H2 receptors i. Ex: cemetidine (Tagament), ranitidine (Zantac), and famotidine (Pepcid) 1. **Give drugs with meals and at bedtime c. Anti-ulcer/Cytoprotective Agents : protect ulcers form acid and pepsin i. Ex: sucralfate (Carafate) 1. **Give drug on an empty stomach 1 hr before or 2 hrs after meals and at bedtime d. Proton Pump Inhibitors : Suppress gastric acid by clocking enzymes associated with the final step of acid production i. Ex: omeprazole (Prilosec), and Iansoprazole (Prevacid) 1. **Give before meals to prevent upset stomach e. GI Motility Agents : Stimulate upper GI tract and gastric emptying without stimulating release of gastric acid i. Ex: Metoclopramide (Reglan), cisapride (Propulsid) (*give 15 min before each meal and at bedtime), and bethanechol (Urecholine) (*administer on empty stomach) f. Anticholinergics : Relaxes smooth muscles of GI tract and inhibits gastric secretions i. Ex: atropine sulfate (Atropine), dicyclomine HCl (Bentyll), and propantherline bromide (Pro- Banthine) 1. **Give 30 mins before meals and ensure adequate fluid intake g. Combination Drugs for PUD : Combination medications of anti-ulcer and antibiotic to treat PUD and remove H. pylori infection i. Ex: bismuth subsalicylate (BSS), metronidazole (MTZ), and tetracycline hydrochloride (TCN) (Helidac) v. Nursing Management 1. Educate client with GERD about diet and lifestyle changes 2. Dietary Management
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16 a. Avoid items that lower pressure in the LES (alcohol, chocolate, peppermint, licorice, citrus fruits, caffeine, high-fat foods) b. Stop smoking c. Avoid food and drinks for several hours before bedtime b. Esophageal Diverticulum i. A sac or pouch in one or more layers of the wall found at the junction of the pharynx and the esophagus or in the middle or lower portion of the esophagus.
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  • Fall '18
  • soreness, Medical and Surgical Management

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