Acid-Controlling Drugs

Question 0

Cimetidine (Tagamet)

Chemical Classification

Answer 0

Imidazole Derivative

Question 1

Cimetidine (Tagamet)

Functional Classification

Answer 1

H2-histamine receptor antagonist

Question 2

Cimetidine (Tagamet)

Mechanism of Action

Answer 2

Inhibits histamine at H2-receptor site in the gastric parietal cells, which inhibits gastric acid secretion

Question 3

Cimetidine (Tagamet)

Uses

Answer 3

Short-term treatment of duodenal and gastric ulcers and maintenance; management of GERD (PO) and Zollinger-Ellison syndrome; prevention of upper GI bleeding; prevent, relieve heartburn, acid indigestion, upper GI bleeding

Question 4

Cimetidine (Tagamet)

Contraindications

Answer 4

Hypersensitivity

Question 5

Cimetidine (Tagamet)

Side Effects

Answer 5

CNS: Constipation, Headache, depression, dizziness, anxiety, weakness, psychosis, tremors, SEIZURES
CV: bradycardia, tachycardia, DYSRHYTHMIAS
GI: Diarrhea, abdominal cramps, PARALYTIC ILEUS, JAUNDICE
GU: gynecomastia, galactorrhea, impotence, increase in BUN, creatinine
HEMA: AGRANULOCYTOSIS, THROMBOCYTOPENIA, NEUTROPENIA, APLASTIC ANEMIA, INCREASE IN PT
INTEG: urticaria, rash, alopecia, sweating, flushing, EXFOLIATIVE DERMATITIS
RESP: PNEUMONIA

Question 6

Cimetidine (Tagamet)

Nursing Considerations

Answer 6

ASSESS:

• Gastric pH(>/=5 should be maintained); epigastric pain, duration, intensity; aggravating, ameliorating factors
• I&O ratio, BUN, creatinine, LFTs, CBC with differential periodically

Question 7

Famotidine (Pepcid)

Functional Classification

Answer 7

H2-histamine receptor antagonist

Question 8

Famotidine (Pepcid)

Mechanism of Action

Answer 8

Competitively inhibits histamine at histamine H2-receptor site, thus decreasing gastric secretion while pepsin remains at a stable level

Question 9

Famotidine (Pepcid)

Uses

Answer 9

Short-term treatment of active duodenal ulcer, maintenance therapy for duodenal ulcer, Zollinger-Ellison syndrome, multiple endocrine adenomas, gastric ulcers; gastroesophageal reflux disease, heartburn

Question 10

Famotidine (Pepcid)

Contraindications

Answer 10

Hypersensitivity

Question 11

Famotidine (Pepcid)

Side Effects

Answer 11

CNS: Headache, Dizziness, paresthesia, depression, anxiety, somnolence, insomnia, fever, SEIZURES IN RENAL DISEASE
CV: DYSRHYTHMIAS, QT PROLONGATION (IMPAIRED RENAL FUNCTIONING)
EENT: taste change, tinnitus, orbital edema
GI: Constipation, nausea, vomiting, anorexia, cramps, abnormal hepatic enzymes, diarrhea
HEMA: THROMBOCYTOPENIA, APLASTIC ANEMIA
INTEG: rash, TOXIC EPIDERMAL NECROLYSIS, STEVENS-JOHNSON SYNDROME
MS: myalgia, arthralgia
RESP: PNEUMONIA

Question 12

Famotidine (Pepcid)

Nursing Considerations

Answer 12

ASSESS:

• ULCERS: epigastric pain, abdominal pain, frank or occult blood in emesis, stools
• Intragastric pH, serum creatinine/BUN baseline and periodically
• Blood counts during therapy; watch for decreasing platelets; if low, therapy may have to be discontinued, restarted after hematologic recovery
• For bleeding, hematuria, hematuresis, occult blood in stools; abdominal pain
• BLOOD DYSCRASIAS (THROMBOCYTOPENIA): bruising, fatigue, bleeding, poor healing

PERFORM/PROVIDE:
-Increase in bulk and fluids in diet to prevent constipation

Question 13

Sucralfate

Functional Classification

Answer 13

Protectant, antiulcer

Question 14

Sucralfate

Chemical Classification

Answer 14

Aluminum hydroxide, sulfated sucrose

Question 15

Sucralfate

Mechanism of Action

Answer 15

Forms a complex that adheres to ulcer site, absorbs pepsin

Question 16

Sucralfate

Uses

Answer 16

Duodenal ulcer, oral mucositis, stomatitis after radiation of head and neck

Question 17

Sucralfate

Contraindications

Answer 17

Hypersensitivity

Question 18

Sucralfate

Side Effects

Answer 18

CNS: drowsiness, dizziness
GI: Dry Mouth, Constipation, nausea, gastric pain, vomiting, bezoar (for critically ill patients)
INTEG: urticaria, rash, pruritus

Question 19

Sucralfate

Nursing Considerations

Answer 19

ASSESS:

• GI SYMPTOMS: abdominal pain, blood in stools
• HYPOGLYCEMIA: may occur in patients with diabetes mellitus