Gastrointestinal Disorders and Treatments Discussion - Essay Example

Gastrointestinal disorders and treatments discussion due: Gastroesophageal reflux disease (GERD) will be the topic of discussion. The most common signs include heartburn, inflammation of the esophagus and acid regurgitation. In order to diagnose GERD accurately, it is important to assess laryngeal thoroughly. Diagnosis of the illness includes Bernstein test, endoscopy, 24hr ambulatory PH, a short course of acid suppressive treatment, and patient’s signs and symptoms (Richter & Castell, 2012). (PPIs) Proton pump inhibitors and (H2RAs) H2-receptor antagonists class of drugs is used for gastroesophageal reflex disorder therapy.

For short-term treatment, PPIs are more effective compared to H2RAs (Karch, 2013). The two drugs act by repressing the production of acid from the stomach. The PPIs drugs reduce but do not prevent the risk of developing ulcers in people taking NSAIDs (Song, Zhu & Lu, 2015).There is evidence that a dose of 75mg ranitidine and famotidine 10mg helps to minimize gastric acidity for at least 12h at night though it is a lower dose than the one in the prescription product insert. The PPIs are more effective in the prevention of acute peptic ulcer bleeding and ulcer healing.

However, a standard dose of H2RAs is efficient in the prevention of NSAID- induced injury such as duodenal but not gastric ulcers (Mejia & Kraft, 2009). The PPIs are efficient in inhibition of gastric acid production. The commonly used drugs include rabeprazole, lansoprazole, omeprazole, pantoprazole and esomeprazole. These drugs are weak bases that require an acidic surrounding to obstruct H+K+ -ATPase and act as prodrugs. The PPIs also reduce pepsin secretion that acts to minimize mucosa harm.

Moreover, the morning dosage of PPIs enhances acid repression that is in contrast with H2RAs that works well at night. The drugs’ effect increase with repeated administration where by day three a steady state happens and the amount of pumps that is inhibited for more than two hours get to 70%. An increase in enzyme recruitment promotes progressive acid suppression. Nevertheless, taking the drugs ‘when required’ does not generate sufficient acid inhibition and does not give a regular clinical reaction.

PPIs and H2RAs should not be used together because of their minimum inhibitory impact. If there is a need for concomitant treatment, it is advisable to provide enough intervals in the administration of the two drugs. The H2RAs are safe to use and can be obtained over-the-counter. However, for elderly patients in the intensive care unit suffering from renal and hepatic difficulties, it produces adverse effects such as headaches, change in mental status, confusion and restlessness. In conclusion, the PPIs medicines reduce the bioavailability of substances with acid-dependent absorption.

The PPIs are safe to administer pharmacologically and clinically, but there are three major worries in regard to long-term use. They include the likely relation of PPIs with chronic hypochlorhydria, gastric atrophy, and prolonged hypergastrinemia. The PPIs are also associated with other complications such as community-acquired pneumonia, hip fractures and renal problems (Mejia & Kraft, 2009). ReferencesKarch, A. M. (2013). Focus on nursing pharmacology. S.l.: Wolters Kluwer Health.Song H, Zhu J, Lu D. (2015). Effect of the long term use of proton pump inhibitors on the rate ofpre-cancerous lesions in the stomach.

Retrieved April 14, 2015, from http://www.cochrane.org/CD010623/UPPERGI_effect-of-the-long-term-use-of-proton-pump-inhibitors-on-the-rate-of-pre-cancerous-lesions-in-the-stomachMejia, A., & Kraft, W. (2009, May 1). Acid peptic diseases: Pharmacological approach to treatment. Retrieved April 14, 2015, from http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3149864/Richter, J. E., & Castell, D. O. (2012). The esophagus. Chichester, West Sussex: Blackwell.