H2 BLOCKERS &PPI Flashcards
What is the prototype medication in Antacids?
Aluminum hydroxide
What is the pharmacological action of an antacid?
The Rx neutralize or reduces gastric acid, also is can reduce pepsin if the pH is > 5
In what three conditions is an antacid used?
Treatment (TX) of Peptic Ulcer Disease (PUD), Prevention of stress-induced ulcers, and relief of the symptoms of Gastric Reflux Disease (GERD).
What are the adverse effects of an antacid?
Constipation with (Aluminum and Calcium compounds, & in Magnesium compounds-diarrhea)
Contraindications for antacids
Use with caution in clients who have GI perforation or obstruction & or abdominal pain.
What are drug interactions with antacids?
Antacids decrease the absorption of ranitidine and cimetidine, Next, Aluminum compounds bind to warfarin, digoxin, and tetracycline, so it interferes with absorption which reduces their effects.
What are important medication teaching instructions for antacids?
Do not take other medications within 1–2 hours of taking aluminum compounds without provider approval, chew tablets completely and then drink at least 8 oz of water or milk. Shake liquids, Take the Rx at least 1 hour before or after taking an antacid.
What are the routes of administration?
oral and liquids
If an antacid contains sodium, what should patients or clients know?
Antacids containing sodium can result in fluid retention. Avoid antacids that contain sodium if a person has hypertension (HTN) or heart failure (CHF, or HF). Last, alkalosis is a risk with sodium antacids.
Magnesium antacids can lead to toxicity and hypomagnesemia for those persons who have impaired kidney function.
What is the expected action for Misoprostol ? (3 things to remember)
1) Decreases acid secretion, 2) increases the secretion of bicarbonate & protective mucus 3) Promotes vasodilation to maintain submucosal blood flow* All these actions help to prevent gastric ulcers**
What class is Misoprostol ?
Prostaglandin E analog
What is the therapeutic Use for Misoprostol?
Given for patients or clients who take long-term NSAIDs (useful to prevent gastric ulcers)
What are the adverse effects of Misoprostol?
Diarrhea, Dysmenorrhea & spotting
What are contraindications of Misoprostol?
- The client must have a negative blood ( serum ) test 2 (two) weeks before starting on this medication ( an unlabeled use in pregnant patients this Rx can induce labor by causing cervical ripening ) hence the medication should start on the second or third day of the one’s menses. * Contraindicated in lactating mothers- it could cause diarrhea in an infant.
What class is Ondansetron (Zofran)?
Antiemetic
What is the therapeutic use for Ondansetron (Zofran)?
For chemotherapy -induced nausea and vomiting
What are the routes of administration ?
Oral (tablets or syrup) rectal, IV or IM
What are the adverse effects of Ondansetron (Zofran)?
Abdominal pain, diarrhea, dizziness, drowsiness, headache, myalgia at the injection site, prolong QT (in the Ventricles- it takes longer for the heart to recharge between the beats).
** For oral administration, what should the nurse teach the patient?
For an oral tablet in a blister pack, peel the foil do not push the tablet through- immediately place on the tongue swallow with saliva-
H₂ Receptor antagonist what is the expected action?
Block Histamine receptors, hence this suppresses gastric acid and lowers the concentration of hydrogen in the stomach
What is the use of an H₂ blocker?
Prevention and treatment for both gastric and duodenal ulcers & GERD & also used in conjunction with antibiotics to treat ulcers caused by H. pylori
What are adverse effects of an H₂ blocker?
Decreased libido, gynecomastia & impotence (adverse effects reverse when stopping the medication) in persons > 65 who have kidney or liver dysfunction CNS effects-lethargy & hallucinations, constipation, diarrhea & nausea
What are contraindications for an H₂ blocker?
H₂ blockers decrease gastric acidity, which can promote bacteria in the stomach and the respiratory tract. Use with caution for patients who are at a high risk for pneumonia or who have COPD-reduce dosing for persons with moderate to severe kidney disease.
Avoid, ETOH, and foods that increase GI irritation-
What are medication interactions with H₂ blockers?
In those persons taking warfarin H₂ blockers can increase the levels of warfarin-hence monitor for bleeding, also for phenytoin ( Dialntin) theophylline & lidocaine ( so monitor blood levels as dosing may need adjusting. If a person also concurrently uses antacids-instruct the patient do not take an antacid 1 hour before or after taking an H₂ blocker-Last, ***smoking can decrease the absorption of an H₂ blocker-stop smoking or at least avoid smoking after the final dose of the day
