Term
|
Definition
| pH < 4 in esophagus for >15 sec |
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Term
|
Definition
1. Physiologic
2. Functional
3. Pathogenic (FTT)
4. Secondary unresponsive to treatment |
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|
Term
|
Definition
1. Emesis
2. Esophagitis
3. Infant spells (presents seizure-like)
Respiratory
4. Sandifer's syndrome (neck tilting) |
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Term
| Why is reflux more common in infants? |
|
Definition
1. Slowed gastric emptying
2. LES pressure is less
3. Esoph. Peristalis |
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|
Term
| What is the gold standard dx of GERD |
|
Definition
|
|
Term
| What are 3 methods to dx GERD? |
|
Definition
1. Barium swallow
2. Biopsy
3. Intra-esoph pH monitor (pH probe) |
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|
Term
| Nonpharm treatment of GERD |
|
Definition
1. position change
2. Avoid second-hand smoke
3. Alter feeding
4. Avoid some foods |
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|
Term
| What type of foods should be avoided in GERD? |
|
Definition
1. Foods that decrease LES tone
2. Foods that in gastric acid (fatty, citrus, tomato, coffee, soda, alcohol |
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|
Term
| What type of meds should be avoided in GERD? |
|
Definition
1. anticholinergics
2. xanthines(caffeine)
3. CCB
4. prostaglandins (NSAIDS) |
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|
Term
| How can feeds be altered to treat GERD? |
|
Definition
1. Thicken with rice
2. Smaller portions
3. Change formula type to soy or elemental |
|
|
Term
| Describe the Nissen Fundoplication surgery |
|
Definition
| Wrap stomach around the espoh. to increase pressure |
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|
Term
| First-line med for GERD and typical dosing in PEDs? |
|
Definition
H2 (ranitidine, famotidine)
Start aggressive 8-10mg/kg/day |
|
|
Term
| What is the common duration of pharm treatment in peds for GERD? |
|
Definition
| ~6mo and then wean as LES has likely gotten stronger, and the meds are no longer needed |
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|
Term
| T/F there is evidence for treating infants with PPI? |
|
Definition
|
|
Term
| When should a PPI be administered? |
|
Definition
30min before meal.
Do not worry about first feeding of the day or middle of the night feeding. |
|
|
Term
| Where is Erythromycin's place in peds GERD treatment? |
|
Definition
| Older kids | other treatments failed |
|
|
Term
| What is a side effect of Bethanechol? |
|
Definition
|
|
Term
| What prokinetic agents are available for treating peds GERD? |
|
Definition
Bethanechol
Erythromycin
Metoclopramide (no longer used)
Cisapride(discontinued) |
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|
Term
| CASE 1: 4mo presents to pharmacy. Cranky all the time. No fever. what questions need to be asked? |
|
Definition
1. How long?
2. Teething?
3. Describe feeding
4. Describe bowel movements
5. Describe vomitting
6. Medications?
7. GERD symptoms? |
|
|
Term
| Describe GERD esophagitis symptoms |
|
Definition
1. chest pain
2. Irritability
3. Feeding trouble
4. Anemia
5. Hematemesis
6. Esoph obstruction |
|
|
Term
| Describe GERD respiratory symptoms |
|
Definition
1. recurring pneumonia
2. Wheezing
3. Apnea
4. Stridor
5. Cough
6. Hiccups |
|
|
Term
| Case 1: Baby has signs of GERD (cries after feeding turns head away, arches back while feeding, spit-up w/ crying) Hieght/weight are normal |
|
Definition
Star with non-pharm
1. thicker feeds
2. smaller feeds
3. change formula type
3. |
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