Indigesion

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Indigesion

  1. 1. Made by: mohammed alrjoub To: Dr. Adham Abu taha
  2. 2.  Indigestion and Dyspepsia are terms commonly used to describe a range of somewhat vague symptoms in the upper GIT that are generally associated with the ingestion of food.
  3. 3.  Indigestion has many possible causes like Lifestyle: 1. Overeating or eating too quickly. 2. Fatty, greasy or spicy foods. 3. Too much caffeine, alcohol, chocolate or carbonated beverages. 4. Smoking. 5. Anxiety. 6. Certain antibiotics, pain relievers and iron supplements.
  4. 4.  Gastritis, Peptic ulcers.  Gallstones, Constipation.  Pancreas inflammation (pancreatitis).  Stomach cancer, Intestinal blockage.  intestinal ischemia .  Indigestion with no obvious cause is known as functional dyspepsia or nonulcer stomach pain.
  5. 5. Early fullness illness during a meal. Discomfort Burning Bloating Nausea. Signs and Symptoms
  6. 6.  weight loss or loss of appetite.  Repeated vomiting or vomiting with blood.  Black, tarry stools.  Trouble swallowing that gets progressively worse.  Fatigue or weakness, which may be symptoms of anemia.  Seek immediate medical attention if you have: 1. Shortness of breath, sweating or chest pain radiating to the jaw, neck or arm. 2. Chest pain on exertion or with stress.
  7. 7.  Lifestyle control.  Antacids.  Aalginates.  H2-antagonistis.  PPI.  Domperidone.
  8. 8.  The compounds used as antacids are: 1. sodium and potassium bicarbonates 2. calcium carbonate 3. aluminium hydroxide 4. magnesium and bismuth salts 5. magnesium–aluminium complexes.  MOA: These are weak bases that dissociate to form alkaline salts, thereby neutralizing gastric acidity.
  9. 9.  MOA: Alginates act as reflux suppressants, they form a sponge-like polymer matrix, forming barrier.  They include: 1. Alginic acid 2. Magnesium alginate 3. Sodium alginate.
  10. 10.  Compounds available are : Famotidine, Ranitidine.  H2-antagonists are more effective treatments than antacids for non-ulcer dyspepsia.  H2 receptor antagonists occupies receptor sites on the parietal cells (H+/K+ ATPase) blocking their activity.
  11. 11.  Famotidine: 10 mg for symptomatic relief or 1 hour before consuming food or drink that causes symptoms; maximum dose 20 mg in 24 hours.  Ranitidine: 75 mg for symptomatic relief, followed by 75mg 1 hour later if symptoms persist; maximum dose 300 mg in 24 hours.
  12. 12.  H2 antagonists are well tolerated and the incidence of side-effects is low.  They should not be sold to patients taking NSAIDs drugs, these may mask the symptoms of developing peptic ulcer.  H2 antagonists are not licensed for sale to pregnant or breastfeeding women.
  13. 13.  Omeprazole is a selective proton pump inhibitor.  It directly inhibits the H+/K+ ATPase of the parietal cells of the stomach responsible for gastric acid secretion.  It is indicated primarily for pt’s with chronic, intermittent, relapsing disorder of varying frequency and severity.  Who experience recurrent attacks, including at night, which can be distressing and negatively affect quality of life.
  14. 14.  The initial dose is tow 10 mg tablets once daily, swallowed whole before a meal, with plenty of liquid.  Omeprazole is licensed as OTC in adults aged 18 years and over. It should not be used by pregnant or breastfeeding women.  Caution should be taken when using anticoagulants and antiepileptics with them (due to CYP450).
  15. 15.  Domperidone is a D2 receptor antagonist.  Domperidone is licensed for the treatment of dysmotility symptoms of dyspepsia, including sensations of fullness, bloating, ‘heavy stomach’, belching and nausea.  The recommended dose is one 10 mg tablet three times daily and at night, when required. The drug is licensed for use in adults aged 16 years and over.
  16. 16.  Not recommended during pregnancy or breastfeeding.  Gastric pathology.  Impaired hepatic or renal function.  With prolactinoma.
  17. 17.  Antispasmodics.  antiflatulents and carminatives.

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