Mt news -3-11.indd

Spring 2011
HEALTHWISE
Gastroesophageal refl ux disease, or GERD, patient and physician to decide if drug therapy is one of the most diagnosed diseases in the is appropriate, and if so, which medication may United States. It is commonly described as benefi t the patient most. bothersome heartburn that occurs once to twice Side Effects & Risks of Drug Treatments
a week and may last from a few minutes up to an Patients should be aware that medications hour, possibly longer, if not treated. The burning used to treat GERD have the potential for side sensation is caused by a back-up of acidic effects as described in the chart below. While stomach contents into the throat. Symptoms these are the most common side effects, this is not an exhaustive list. Other, less common, conditions like chest pain, so it is important for side effects may occur. Patients should become a physician to get a thorough medical history of Symptoms of GERD
familiar with these prior to using any therapy Main Symptom
Burning in one’s chest, generally
H Blockers
after eating
Treatments for GERD
Treating GERD can include both lifestyle Other Symptoms
changes and medication. Lifestyle changes • Hoarseness
• Laryngitis
• Sore throat
• Chronic dry cough
(especially at night)
• Avoiding high-fat or spicy “trigger” foods • Bad breath
• Feeling as if you have a
lump in your throat
• Eating small meals throughout the day Alarm Symptoms
lifestyle changes and medication, symptoms may require further testing
can be controlled, potentially eliminating the • Chest pain
need for long-term medication therapy. Some • Painful swallowing
commonly used to treat GERD: histamine-2 patients may remain on medications throughout • Diffi culty swallowing
receptor blockers (H blockers) and proton their lives, though, depending on the severity • Weight loss
pump inhibitors (PPIs). H blockers and PPIs • Bleeding
of their condition, their response to medication, target cells in the stomach that produce gastric • Vomiting
acid and reduce the acidity of stomach contents If your symptoms include chest
that may back up into the esophagus. Each pain, a further heart exam may be
class of medication has different directions necessary.
for use, different side effects and different interactions. It is the responsibility of both the Be Aware of Drug Interactions with PPI’s PPI use and osteoporosis
magnesium levels, including tremors, seizures, The FDA has recently published warnings and heart rhythm abnormalities. If you are regarding the use of PPIs for more than one year concerned about PPI use and low magnesium, and the associated risk of bone loss and bone speak with your physician or pharmacist. breaks. These fi ndings apply mostly to women older than 50. It is recommended that patients PPI use and Plavix® (clopidogrel)
not stop their PPI therapy without speaking to New FDA recommendations address the use their physician to evaluate their risk factors for of PPIs and Plavix® (clopidogrel). Plavix® is a osteoporosis. At-risk patients may need to take prescription medication that keeps blood cells calcium and vitamin D with their PPI.
from clotting. Omeprazole or another PPI is commonly prescribed with Plavix® to protect PPI use and low magnesium
one’s stomach from bleeding. An interaction The FDA also reported that low magnesium may exist between PPIs and Plavix® which could is another potential risk associated with long- decrease the drug level of Plavix® potentially term PPI use. Have your blood checked for placing patients at a greater risk for a heart magnesium levels prior to starting PPIs long- attack or stroke. Persons using Plavix® who are term. Also alert your doctor to additional considering PPI therapy should speak with their medications that may predispose you to having physician or pharmacist before taking GERD low magnesium - diuretics (water pills), digoxin, medication to discuss this potentially serious and others. Serious events are related to low Most H blockers start working within 30 minutes to an hour and exert their greatest effect within 2-3 hours. PPIs take longer to start working, generally 1-3 hours with maximum effect over several days. For optimum results, take your H blocker or PPIs on a regular schedule. Commonly Used Proton Pump Inhibitors (PPI)
Drug Name
Dose for GERD
Common Interactions
Prescription?
Aciphex® (rabeprazole)
Nexium® (esopmeprazole)
Prevacid® (lansoprazole)
Priolosec ®, Prilosec® OTC,
and Zegerid® (omeprazole)
Protonix® (pantoprazole)
Commonly Used H Blockers
Drug Name
Dose for GERD
Common Interactions
Prescription?
Pepcid® (famotidine)
Tagamet® (cimetidine)
Common Interactions with Tagament: Asacol® (mesalamine), Cardizem® (diltiazem), Celexa® (citalo-
pram), Clozaril® (clozapine), Colcrys® (colchicine), Cordarone® (amiodarone), Coumadin® (warfarin), Dilantin® (phenytoin), Glucophage® (metformin), Lexapro® (escitalopram), Nolvadex® (tamoxifen), Plavix® (clopidogrel), Qualaquin® (quinine), Sonata® (zaleplon), Theo-24® (theophylline) Zantac® (ranitidine)

Source: http://bartonccc.edu/administration/hr/documents/benefitinfo/spring2011.pdf