Three new things that I learned this week:

1. Medications such as anticholinergics, theophylline, meperidine, calcium channel

blockers, and foods such as spearmint, peppermint, high fat or high carbohydrate foods

cause decreased lower esophageal sphincter tone, which worsens gastroesophageal reflux

disease (Woo, 2016, p. 1022).

2. The Centers for Disease Control and Prevention (CDC) recommends bismuth

subsalicylate to treat travelers diarrhea, dosing before meals and at bedtime for up to

three weeks (Woo, 2016, p. 506).

3. Antacids have significant sodium content and patients with heart or kidney problems

should be instructed to use low-sodium antacids (Woo, 2016, p. 502). I was not aware

antacids came in low-sodium formula.

Two things that I will make sure that I teach my patients:

1. Antacids should be taken 1-3 hours after meals and separated from most all medications

by at least 2 hours due to the interference of absorption (Woo, 2016, p. 502).

2. Smoking interferes with the absorption of Histamine 2 receptor antagonists (H2RAs)

(Woo, 2016, p. 524). I will be sure of educating my patients of this as well as stressing

that smoking increases gastric acid.

One question I still have:

When going through patients medications, there are so many that are on daily proton pump

inhibitors (PPIs) and Histamine 2 receptor antagonists (H2RAs), and have been on the same

regimen for many years. According to the book, most of these drugs are recommended for short-

term use, then a referral to gastroenterology specialist. Why do you see so many people on PPIs

and H2RAs long term?

Woo, T. M. (2016). Drugs affecting the gastrointestinal system. In T. M. Woo & M. L. Robinson

(Eds.), Pharmacotherapeutics for Advanced Practice Nurse Prescribers (4th ed.), (pp.

497- 540). Philadelphia, PA: F. A. Davis Company.

Linda,

I enjoyed reading your post. I learned a lot of the same things this past week, especially about

the importance of patient education with antacids. I was not very familiar with the causes of

Crohns disease, and your question caused me to do a little research to learn more about this

growing problem. I found a website, Crohns and Colitis Foundation of America (CCFA), which

helped me to understand a little more about the disease. The disease equally effects men and

women and approximately 700,000 Americans have been diagnosed with the disease (Crohns

and Colitis Foundation of America [CCFA], 2016). Crohns is a chronic inflammatory condition

of the bowel, and is believed to be caused by genetic and environmental factors (CCFA, 2016).

According to CCFA (2016), diet and stress are believed to aggravate the disease, and is found

more commonly in developed countries, more urban areas, and more northern climates. This

leads me to wonder if the fast-paced, stressful, fast-food lifestyles that many lead are

contributing to the exacerbation of this disease?

Crohns and Colitis Foundation of America [Internet]. (2016). What is crohns disease? Retrieved

from: http://www.ccfa.org/what-are-crohns-and-colitis/what-is-crohns-disease/