Questions and Case Studies: GERD Medications

00:01 Okay, let's go on to some questions. H2D2, these are not the drugs you are looking for.

00:08 Now, if you don't get the joke, you probably have a social life. Let's move on to the question.

00:12 The following statements pertain to H2 blockers. Pick the false statement.

00:17 A, the H2 blockers are more potent and more effective than the antacids.

00:22 B, they irreversibly inactivate the hydrogen potassium ATPase pump.

00:27 C, cimetidine has antiandrogenic actions at high doses.

00:31 Or D, they inhibit absorption of drugs like ketoconazole.

00:36 Remember that H2 blockers do not irreversibly inactivate the hydrogen-potassium ATPase pump.

00:44 That distinction lies with the proton pump inhibitors.

00:49 Let's move on to another question.

00:52 An 80 year old male with chronic constipation presents with severe gastroesophageal reflux after a large turkey dinner.

01:00 The best choice for acute treatment in this individual is? Aluminium hydroxide? Magnesium hydroxide? Calcium carbonate? Sodium bicarbonate? Or metoclopramide? Good, you chose magnesium hydroxide.

01:21 So when you are looking at these agents, remember that aluminium hydroxide can be constipating.

01:27 This guy already has constipation so maybe it's not a great choice.

01:30 Calcium carbonate and sodium bicarb are weaker antacids.

01:34 Calcium carbonate is found in Tums for example, and sodium bicarb is found in a lot of those effervescent tablets that you buy over the counter.

01:44 Metoclopramide is a promotility agent, but not an effective antacid.

01:49 So it's not treating both problems. The answer here is going to be B, magnesium hydroxide.

01:55 It's also called Milk of Magnesia. It has laxative effects, anti-acid effects, and it's also quite soothing on the elderly bowel.