Acid Controlling Drugs Flashcards
What is the most common cause of Peptic Ulcer Disease (PUD)?
H. pylori
What does data not support in relation to stress ulcer prophylaxis?
Data do not support the continued use of stress ulcer prophylaxis after the patient is no longer in the ICU.
PUD contraindications?
REMEMBER- NSAIDS, Anticoagulants, Anti-platelets are contra-indicated in PUD! Alcohol, Smoking, Steroids!
Important note for antacids?
Antacids are usually NOT administered simultaneously with other medications, or even within 1-2 hours of other medications
Examples of Antacids?
- aluminum
- magnesium salts
- calcium salts
- sodium bicarbonate
What are Antacids used to treat?
- GERD/Heart burn
- ALUMINUM- Hyperphosphatemia due to CKD (except magnesium!)
- NOT for treating PUD
What do many antacid combinations include?
Many antacid combinations include simethicone. Know simethicone (Gas-X). This reduces surface tension of gas bubbles
Aluminum Salts unique adverse effect?
Has constipating effects
What are Aluminum Salts used to treat?
Can be used in CKD to treat hyperphosphatemia.
Magnesium Salts unique adverse effects?
Commonly cause diarrhea
Magnesium Salts contraindication?
Dangerous when used with renal failure
Calcium Salts unique adverse effects?
- Constipation
- Kidney stones
- Milk Alkali Syndrome (don’t give with milk!)
- Rebound Hypersecretion of Acid
Sodium Bicarbonate unique adverse effects?
Sodium content may cause problems in patients with heart failure (HF), hypertension, or renal insufficiency.
What is Simethicone used to treat?
Gas Pain
What are examples of Histamine 2 Receptor Antagonists (H2RAs)?
- cimetidine
- ranitidine
- famotidine
What are H2RAs used to treat?
- Peptic Ulcer Disease (PUD)
- GERD
- Stress Ulcer Prophylaxis (SUP)
- Immune responses (histamine blockade)
H2RAs adverse effects?
1st Generation- Cimetidine
- Anti-Androgen
- Liver Enzyme Inhibition
2nd Generation- Ranitidine, Famotidine
- no androgen/liver issues
H2RAs nursing considerations?
- Kidney Disease/Geriatrics (monitor for CNS effects like drowsiness)
- pH change in the GI Tract (monitor for infection including C.diff and pneumonia)
- H2RAs and antacids should be administered at least 1-2 hours apart
Example of Proton Pump Inhibitor/PPI?
Omeprazole
What is Omeprazole used to treat?
- G.I. Bleed
- Peptic Ulcer Disease (PUD)
- GERD
- Stress Ulcer Prophylaxis (SUP)
Omeprazole adverse effects?
- diarrhea
- change in gut pH (increased risk for C.diff and pneumonia)
- change in absorption of electrolytes (hypomagnesemia, hypocalcemia)
Omeprazole nursing considerations?
Monitor for long term treatment complications:
- Osteoporosis (Vitamin D + Calcium intake)
- Pneumonia/C.Diff
- Magnesium (monitor for muscle cramps, more dangerously- seizures)
Example of Anti-Ulcer?
Sucralfate (treats PUD)
How should Omeprazole be administered?
Patients should take first thing in the morning, 30 minutes before their first meal
Sucralfate nursing considerations?
- Patients may develop constipation- encourage fiber intake
- Administer on empty stomach for best mechanism
- Separate administration of other drugs (2 hours before/after)
What is Bismuth Subsalicylate used to treat?
- Diarrhea (traveler’s diarrhea)
- Indigestion/Heartburn
Bismuth Subsalicylate adverse effects?
- May stain tongue, bowel movements green/black
- Avoid in children
- Chronic use could accumulate (risk for salicylism)
Antibiotic Regimen for H. pylori?
Minimum of two antibiotics prescribed (up to three may be used) to reduce risk of resistance developing FOR 2 WEEKS (14 days)
- Amoxicillin
- Clarithromycin
- Bismuth compounds
- Tetracycline
- Metronidazole
Example of Prostaglandin Analog?
Misoprostol
What is Misoprostol used to treat?
- Ulcers
- Promotes Cervical Ripening (Labor Induction)
- Treat Postpartum Hemorrhage
- Can be used for termination of Pregnancy
Misoprostol adverse effect?
- Diarrhea, abdominal pain
- Spotting, dysmenorrhea
- Pregnancy Category X
