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Heartburn: Appropriate Use of OTC Medications

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Overview

Heartburn is a burning sensation in the chest that may radiate toward the neck, throat, and occasionally, the back. It most often results from the reflux of gastric contents into the esophagus. Heartburn is among the most common gastrointestinal complaints, and is a common reason people seek medical care. The worldwide prevalence of reflux symptoms that occur at least once a week is estimated to be 13%, but varies widely among countries. In the US, the prevalence ranges from 6% to 30%. It is higher among individuals who are 50 years or older, those who are smokers, nonsteroidal antiinflammatory drug (NSAID) and/or aspirin users, and obese individuals.

Heartburn and regurgitation are the typical symptoms of gastroesophageal reflux disease (GERD). GERD is defined as the effortless movement of stomach contents into the esophagus or mouth, which leads to troublesome symptoms and/or complications. Heartburn is a symptom – GERD is a disease. Heartburn is differentiated from GERD based on symptom frequency and severity, and the impact of symptoms on quality of life. Reduced quality of life is linked with frequent symptoms – especially nocturnal symptoms, which can lead to sleep disturbances that impair next-day functioning.

Men and women are equally affected by GERD, but men are at greater risk of developing complications – mainly erosive esophagitis, Barrett’s esophagus, and esophageal cancer. GERD should be managed by a health care provider, as patients may need long-term therapy and ongoing monitoring for complications. In contrast, heartburn can often be managed with appropriate self-care including lifestyle changes and over-the-counter (OTC) medications...

Details

Publication Date: 12/20/2018
Expiration Date: 12/20/2021
CE Credit: 1.5 (0.15 CEU)
Type of Activity: Knowledge-based

This program was developed by The Rx Consultant and published by Continuing Education Network, Inc. The Rx Consultant accepts no advertising or financial support from the pharmaceutical industry and is funded solely by the purchase of programs. The Rx Consultant is dedicated to providing unbiased, balanced information to health care practitioners.

Programs developed by The Rx Consultant are written by health care providers with expertise in the topic area, peer-reviewed, extensively edited, and fact-checked. This development process was created to insure that every program presents information that is current, accurate, relevant to "real world" health care providers, and written in an easy reading, "plain English" style.

Authors

Tara R. Whetsel, PharmD, BCACP, BC-ADM is an Associate Professor in the Clinical Pharmacy Department, West Virginia University School of Pharmacy in Morgantown, West Virginia; and a Clinical Pharmacist at the West Virginia University Medicine Cheat Lake Physicians Family Medicine Clinic and the Milan Puskar Health Right Clinic. Dr. Whetsel co-authored the Heartburn and Dyspepsia chapter in the Handbook of Nonprescription Drugs: An Interactive Approach to Self-Care, 2018 (19th ed).

Disclosure Statement

Dr. Whetsel reports no financial relationship with the manufacturer(s) or provider(s) of any commercial product(s) or service(s) that appear in this issue.

Target Audience

This accredited program is targeted to pharmacists and nurses.

Goals & Objectives

At the conclusion of this program, participants will be able to:

    1. Describe heartburn and indicate when self-care with over-the-counter (OTC) medications is appropriate. Recommend lifestyle changes that may help prevent or reduce heartburn.
    2. Describe the main differences among antacids, histamine-2-receptor antagonists (H2RAs), and proton pump inhibitors (PPIs) in the treatment of heartburn. Educate patients about the proper administration of each.
    3. Summarize safety concerns for OTC heartburn medications including potential drug interactions, use in special populations, and the unique concerns with PPI therapy.

Accreditation Statements

The Rx Consultant is a publication of Continuing Education Network, Inc.

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Continuing Education Network, Inc. is accredited by the Accreditation Council for Pharmacy Education as a provider of continuing pharmacy education as a provider of continuing pharmacy education.

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Continuing Education Network is approved by the California Board of Registered Nursing, Provider Number CEP 13118. Programs approved by CA BRN are accepted by most State Boards of Nursing.

ACPE Universal Activity Number: 0428-0000-18-024-H01-P


Exam & Credit Statement Procedures

Upon successful completion of this program and the post test (70%), 1.5 hours of continuing education credit will be awarded. To receive credit and your exam score, please complete the exam questions and program evaluation.

Editorial and Review Board

Chief Editor and CE Administrator


Terry M. Baker, PharmD

Managing Editor


Tracy Farnen, PharmD

Associate Editors


James Chan, PharmD, PhD
Pharmacy Quality and Outcomes Coordinator
Kaiser Permanente
Oakland, CA

Associate Clinical Professor
School of Pharmacy
University of California San Francisco
San Francisco, CA

Richard Ron Finley, B.S. Pharm.,R.Ph.
Clinical Pharmacist (volunteer faculty)
University of California, San Francisco (UCSF) Memory and Aging Center
Lecturer (Emeritus) UCSF, Department of Clinical Pharmacy
Health Sciences Clinical Professor, UCSF School of Pharmacy
San Francisco, CA

Consultant Pharmacist
Ray Dolby Brain Health Center, Sutter Health/CPMC
San Francisco, CA

Consult Pharmacist Aging and Adult Health Services
San Francisco Health Department
San Francisco, CA

Julio R. Lopez, PharmD, FCSHP
Chief of Pharmacy Service
VA Northern California Health Care System

Adjunct Clinical Professor
College of Pharmacy
Touro University
Vallejo, CA

Assistant Clinical Professor
School of Pharmacy
University of California, San Francisco
San Francisco, CA Adjunct Professor
Thomas J. Long School of Pharmacy
University of the Pacific
Stockton, CA

Visiting Associate Professor and Lecturer
Nursing School
Samuel Merritt University
Oakland, CA

Pamela Mausner, MD

Helen Berlie, Pharm.D. CDE, BCACP
Clinical Assistant Professor, Pharmacy Practice
Wayne State University
Detroit, MI

Ambulatory Care Specialist - Diabetes
Health Centers Detroit Medical Group
Detroit, MI

Senior Editorial Advisor


Gerard Hatheway, PharmD, PhD

Editorial Advisors


Belinda M. Danielson, RPh
Christopher M. DeSoto, PharmD
Angie S. Graham, PharmD
Cynthia Chan Huang, PharmD, MBA
Fred Plageman, PharmD

Editorial Advisor and Clinical Practice Consultant for Nurse Practitioners


Emily K.
Meuleman, RN, C, MS

About the Rx Consultant

The Rx Consultant is a monthly publication dedicated to providing health care professionals with the information they need to educate patients about drugs and manage drug therapy. The reader is responsible for confirming the information presented here and interpreting it in relation to each patient's specific situation before utilizing the information.

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