asmi
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Name the Drugs which predisposes to Gastroesophagial reflux disease?
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| meg
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anticholinergics, theophylline, caffeine(not a drug.. but can), benzodiazipines, calcium channel blockers.
Which is the drug that the patient should be advised not to lie down after taking it ? It is in the back of my head, and dont have access to Kaplan notes for a few hours... anyone remembers? I feel it is etindronate.. but I may be wrong.... :oops:
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| asmi
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Thx
Also Beta blockers and nicotine.
About the other one,plz do tell me.
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| meg
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Yes, the other one is Alendronate(same family as etindronate). It is given in hypercalcemic states(like Pagets, cancer chemotherapy) and it inhibits osteoclastic bone resorption. The patients should be advised to sit upright/not lie down for at least 1 hour after taking it, to prevent esophageal ulceration.
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| asmi
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thx Meg!
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| asmi
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Meg,
It seems Beta blockers doesnot predispose to GERD.
Do you have any idea?
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| leftfoot
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i think the explanation could be...
beta blockers predispose to unopposed parasympthetic action on the LES which is LES contraction! :!:
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| asmi
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so do you mean its correct that beta blockers can predispose to GERD ?
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| leftfoot
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no...
parasympathetic action on the LES is "LES contraction"( which would prevent reflux and hence GERD)
beta blockers would block symp action and hence enhance parasymp action on the LES....
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| asmi
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oops my mistake.
Thanks
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| asmi
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What are the complications of GERD ?
Name the drugs used to treat it ?
Is there any organism associated with this disease? If yes, how do you identify it ?
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| leftfoot
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the most imp complication of GERD is berret's esophagus :arrow: adenocarcinoma of the lower third of the esophagus
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| asmi
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other unimp. complications are bleeding,stricture,bronchospasm.
sjogrens syndrome is also one of the exacerbating factor.
treatment : antacids ,H2 blockers, Proton pump blockers.
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| leftfoot
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how does GERD cause bronchospasm...?
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| meg
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I think by reflex if aspirated.
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| deepshikha
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dr patel..GERD causes barretts esophagus wich is squamous metaplasia of the esophagus and DOES NOT cause adenocarcinoma!!!
meg..by reflex?how r u saying that?the reflux in GERD is of stomach acid contents into esophagus..how is anything reaching the bronchus?wud u pls clarify?
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| leftfoot
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adinocarcinoma of the distal esophagus is the most important complication of berret's esophagus...
though berret's esophagus may also cause squamous cancer( thats usually involves the mid-esophagus..."smoking-alcohol" are more important in its pathogenesis than berret's)
also...when meg said 'reflex'..she explained..."if aspirated"
aspiration means...going into the respiratory tract.
that may or may not be the right explanation but i think she made a reasonable and logical assumption...you are welcome to enlighten us if you have a better explaination :idea:
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| deepshikha
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i know wht meg meant by reflex..thts wht i askd her..how are u going to aspirate anything from the esophagus/stomach?i want to know how bronchospasm is caused..
im wrong probably about the barrett's esophagus causign squamous ca.. and not adenocarcinoma but thts wht i knew..i apologise if im wrong!
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will be preparing for the USMLE step1 from2005.anyone interested in studying and discussing their preparation with me in kolkata can reach me at deepshikhan@hotmail.com
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| sunman
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smack down!!!
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| Idiopathic
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Any drop of fluid on the bronchus will cause bronchospasm. Any gastric contents regurgitated up into the esophagus can potentially find their way into the trachea. Major potential complication of long term severe GERD is possible pleural abscess due to aspiration of acidic gastric contents.
Barret's esophagus causes esophageal adenocarcinoma, the MC cancer in the esophagus.
Caffeine does not predipsose to GERD, but coffee (caffeinated and decaffeinated) does...just thought I would make that point.
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| deepshikha
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im really sorry everyone!!i had my basic concept wrong wgich led me to think what i did..i thought there occured SQUAMOUS METAPLASIA in barretts esophagus..and therefore squamous epithelium can never lead to adenocarcinoma..BUT its actually COLUMNAR METAPLASIA wich occurs..and yes..adenocarcinoma IS the most important complication sof barretts esophagus!small mistake by an overconfident(?) person..wud be nice if u people overlooked it...
___________________
will be preparing for the USMLE step1 from2005.anyone interested in studying and discussing their preparation with me in kolkata can reach me at deepshikhan@hotmail.com
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