WBR0728

Author	[[PageAuthor::Yazan Daaboul, M.D. (Reviewed by Yazan Daaboul, M.D.)]]
Exam Type	ExamType::USMLE Step 1
Main Category	MainCategory::Pharmacology
Sub Category	SubCategory::Gastrointestinal
Prompt	[[Prompt::A 48-year-old man presents to the physician's office complaining of heartburn. Following appropriate work-up, he is diagnosed with gastro-esophageal reflux disease (GERD). The patient informs the physician that he has recently been using over-the-counter aluminum hydroxide, which has been effectively relieving his symptoms. Chronic use of aluminum hydroxide is associated with which of the following conditions?]]
Answer A	AnswerA::Diarrhea
Answer A Explanation	AnswerAExp::Magnesium-based antacids are associated with diarrhea.
Answer B	AnswerB::Hyporeflexia
Answer B Explanation	AnswerBExp::Magnesium-based antacids are associated with hyporeflexia.
Answer C	AnswerC::Hemorrhoids
Answer C Explanation	AnswerCExp::Aluminum-based antacids are associated with constipation, which might predispose to hemorrhoids.
Answer D	AnswerD::Hyperkalemia
Answer D Explanation	AnswerDExp::Generally, all antacids are associated with metabolic alkalosis and hypokalemia, not hyperkalemia.
Answer E	AnswerE::Cardiac arrest
Answer E Explanation	AnswerEExp::Although very rare, magnesium-based antacids are associated with cardiac arrest.
Right Answer	RightAnswer::C
Explanation	[[Explanation::Antacids, such as aluminum hydroxide, contain cations that buffer gastric pH. Following the introduction of PPi and H2 receptor antagonists, the role of antacids in GERD has significantly decreased. Nonetheless, they are still used among patients since they are easily accessible over-the-counter drugs. In contrast to magnesium-based antacids which are associated with diarrhea, aluminum-based antacids are associated with constipation, which might predispose patients to hemorrhoids. As such, physicians must be cautious in to educate patients with hemorrhoids about the use of aluminum-based antacids. The following table highlights the adverse effects of antacids: Educational Objective: Aluminum hydroxide is associated with constipation, which might predispose to hemorrhoids. References: First Aid 2014 page 371]]
Approved	Approved::Yes
Keyword	WBRKeyword::Antacid, WBRKeyword::Antacids, WBRKeyword::Adverse, WBRKeyword::Reaction, WBRKeyword::Adverse drug reaction, WBRKeyword::Side, WBRKeyword::Effect, WBRKeyword::Side effect, WBRKeyword::Magnesium, WBRKeyword::Aluminum hydroxide, WBRKeyword::Aluminum, WBRKeyword::Hydroxide, WBRKeyword::Hemorrhoids, WBRKeyword::Gastroesophageal reflux disease, WBRKeyword::Constipation, WBRKeyword::GERD, WBRKeyword::Gastroesophageal, WBRKeyword::Reflux, WBRKeyword::Heartburn
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Order in Linked Questions	LinkedOrder::