Histamine-2 antagonists are administered to reduce the amount of hydrochloric acid secreted in the stomach, which helps to prevent peptic ulcer disease. H2 antagonists do not act as an antibiotic to kill bacteria (i.e., H. pylori) coat and protect the sto
Destroys Helicobacter pylori
Coats and protects the stomach lining
Reduces the amount of hydrochloric acid secreted
Increases the pH of the secreted hydrochloric acid
Proton pump inhibitors suppress the secretion of hydrochloric acid into the lumen of the stomach. Antipeptic agents coat any injured area in the stomach to prevent further injury. H2 antagonists block the release of hydrochloric acid in response to gastri
Proton pump inhibitors
The nurse would be concerned about the patient's nutritional status because lack of digestive enzymes results in malnutrition. Replacement digestive enzymes help the patient improve digestion and absorption of essential nutrients. Effectiveness of the the
Risk for constipation
Risk for imbalanced nutrition
A patient taking antacids should be advised to take the antacid 1 hour before or 2 hours after other oral medications. These tablets are often chewed to increase effectiveness. Limiting fluid intake can result in rebound fluid retention so that patients s
Administer this drug with other drugs or food.
Limit fluid intake to decrease dilution of the medication in the stomach.
Have the patient swallow the antacid whole and do not crush or chew the tablet.
Administer the antacid 1 hour before or 2 hours after other oral medications.
An appropriate dosage and frequency for cimetidine is 800 mg PO at bedtime. Also, 300 mg can be taken q.i.d at meals and at bedtime. Ranitidine is taken 150 mg daily or b.i.d. Famotidine is taken 20 mg PO b.i.d. Nizatidine can be taken 150 to 300 mg PO at
20 mg PO b.i.d
800 mg PO at bedtime
150 mg PO b.i.d
300 mg PO at bedtime
Patients receiving pancreatic enzymes should be taught to avoid spilling the powder on the skin because it can be very irritating. The enzymes should be taken with food and are often in a powder form. Pancreatin and pancrelipase are not interchangeable.
Take the enzymes on an empty stomach.
Pancreatin and pancrelipase are interchangeable.
Crush the capsules and take with food.
Avoid spilling the powder on the skin because it may be irritating.
Prolonged or excessive use of OTC antacids can lead to the development of metabolic alkalosis. Many antacids contain calcium so that low calcium levels would be unlikely. Because metabolic alkalosis is a concern, metabolic acidosis is unlikely. High chole
Rebound tenderness at McBurney's point
If aluminum salts (AlternaGEL) are taken concurrently with sucralfate, a risk of high aluminum levels and related aluminum toxicity exists. The combination of sucralfate and aluminum salts should be avoided or used with extreme caution. Adverse reactions
Milk of Magnesia
Esomeprazole must be swallowed whole, not cut, crushed, or chewed, which would interfere with its effectiveness. The drug should not be taken with an antacid, which could interfere with absorption. The drug is taken once a day, not with each meal.
“I need to swallow the drug whole and not chew the capsules.”
“It is important that I take the drug after each meal.”
“I should always take the drug with an antacid.”
“I should open the capsules and crush the drug into applesauce.”
The 83-year-old man with rheumatoid arthritis is most likely to be taking nonsteroidal anti-inflammatory drugs (NSAIDs). Misoprostol is indicated for prevention of NSAID induced ulcers in adults at high risk for development of gastric ulcers. The other th
A 12-year-old with obsessive-compulsive disorder
A 46-year-old trial lawyer with hypertension
An 83-year-old man with rheumatoid arthritis
A 22-year-old pregnant patient
Cimetidine was the first drug in this class to be developed. It has been associated with antiandrogenic effects, including gynecomastia and galactorrhea. Dizziness, headache, and somnolence are associated with all histamine-2 antagonists.
Nizatidine differs from the other three drugs in that it is eliminated by the kidneys, with no first-pass metabolism in the liver. It is the drug of choice for patients with liver disease or dysfunction.
Gastric acid pump or proton pump inhibitors are recommended for the short-term treatment of active duodenal ulcers, gastroesophageal reflux disease, erosive esophagitis, and benign active gastric ulcer; for the long-term treatment of pathologic hypersecre
Repeated use of antacids can result in rebound acid production because more gastrin is produced when pH of acid level decreases. Patients should be taught that long-term use of antacids requires follow-up care. Calorie and fluid intake does not need to be
Take before each meal and before bed.
Consider liquid diet if diarrhea occurs.
Be aware of risk of acid rebound with long-term use.
Reduce calorie intake to reduce acid production.
Famotidine should be administered 40 mg every day at bedtime or 20 mg b.i.d for treatment of a gastric ulcer. Options A, C, and D are not correct.
60 mg at bedtime
10 mg b.i.d
40 mg q AM
20 mg b.i.d
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