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Gastroesophageal reflux (GER) is the passage of _______ contents into the ____________
Gastroesophageal reflux disease (GERD) is gastric reflux caused by troublesome _________ or ________
symptoms or complications
GER is caused by ________ of lower esophageal sphincter
What are some GERD symptoms in infants?
Regurgitation, feeding difficulties and vomiting up blood
What are some GERD symptoms in children?
Regurgitation, feeding difficulties, vomiting up blood, chest pain, heartburn, and difficulty swallowing
Patients should be referred if experiencing _________ vomiting, GI _________, difficulty _________, history of ________ allergies, ________ or diarrhea/constipation
projectile; bleeding; swallowing; food; fever
What are some non-pharmacologic treatment options for GERD?
feeding changes, positioning therapy and lifestyle changes
Can infants take antacids as a therapy option?
can children take antacids as a therapy option?
yes but short term
What is the pediatric H2RA of choice?
PPIs should be dosed ________ daily for peds patients
Avoid _________ containing products/antacids in peds children
Sucralfate should not be used in _________ and typically only _______ period of time in children
What are some vomiting alarm symptoms?
Vomiting up blood, bilious emesis, dehydration, shock, neurological changes, abdominal dissension and vomiting that wakes child from sleep
What are the causes of constipation?
Anatomic, neurologic, endocrine, obstructive, functional or medications (opioids, antihistamines, chemo, etc...)
What are the complications of constipation?
fetal incontinence, bed wetting, UTIs, rectal ulcerations and social/emotional issues
What is the 1st line of treatment of constipation in infants?
What to avoid in infant management of constipation?
Mineral oil, stimulant laxatives, phosphate enemas
What is the management options of constipation in children?
education, disimpaction/cleanout, maintenance therapy and behavior modification
What is the first line treatment of disimpaction?
Oral (preferred) PEG; magnesium citrate
What is the second line treatment of disimpaction?
rectal (less preferred) NS enema; sodium phosphate enema; mineral oil
What is the first line maintenance agent?
What are other maintenance agents?
lactulose, mg OH, stool softeners (Docusate) and stimulant laxatives
What is non-pharmacologic treatment of diarrhea in children?
restore fluid and electrolytes, temporary diet modification
What is the treatment for dehydration?
mild-mod dehydration: oral replacement therapy
severe dehydration: IV rehydration
What is the Holliday-Segar Method?
up to 10 kg: 100 mL/kg
10-20 kg: 1000 mL+50(every kg>10)
>20 kg: 1500 mL+20(every kg>20)
What are some pharmacologic therapy options for diarrhea?
Loperamide, cholestryamine and opioids
Avoid __________ in children that are malnourished, severe dehydration or have bloody diarrhea
Opioids are not __________ treatment options due to abuse potential
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