Acid-Controlling Drugs Flashcards

1
Q

What are the classes of acid-controlling drugs?

A

Antacids
Histamine (H2) antagonists
Proton pump inhibitors (PPI)

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2
Q

What is the mechanism of action of antacids?

A

Increases gastric pH to neutralize gastric acidity

Antacids DO NOT prevent overproduction of acid

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3
Q

What is the drug effect of antacids?

A

Reduction of pain associated with acid-related disorders (heartburn)

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4
Q

What are the indications for antacids?

A
Symptoms associated with: 
PUD
Gastritis
Heartburn
Hyperacidity
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5
Q

What are the contraindications for antacids?

A

Allergy
Renal failure
Electrolyte disturbances
Gastrointestinal obstruction

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6
Q

What are examples of magnesium-containing antacids?

A

Gaviscon liquid

Milk of magnesium

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7
Q

What are examples of aluminum-containing antacids?

A

Amphogel

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8
Q

What are examples of magnesium and aluminum combo antacids?

A

Maalox

Mylanta

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9
Q

What are examples of sodium-containing antacids?

A

Alka-seltzer

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10
Q

What are examples of calcium-containing antacids?

A

Tums

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11
Q

What are the adverse effects of antacids?

A

Magnesium - diarrhea
Aluminum and calcium - constipation
Calcium - kidney stones
Sodium bicarbonate - alkalosis

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12
Q

What are the interactions concerning antacids?

A

Adsorption of other drugs to antacids reduces ability of other drugs to be absorbed into body
Chelation (chemical inactivation of other drugs)
Increased stomach pH increases absorption of basic drugs and decreases absorption of acidic drugs
Increased urinary pH increases excretion of acidic drugs and decreases excretion of basic drugs

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13
Q

What are nursing implications for antacids?

A

Long-term self medication may mask symptoms of serious underlying diseases (cancer, bleeding ulcers)
Do not take within 1 - 2 hours of taking other medications (affects absorption)
Take tablets with 8 oz of water to enhance absorption
Seek medical evaluation if symptoms remain ongoing

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14
Q

What is the mechanism of action of H2 antagonists?

A

Block histamine at H2 receptors of acid-producing parietal cells, reducing production of hydrogen ions, resulting in decreased production of HCl

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15
Q

What is the drug effect of H2 antagonists?

A

Suppresses acid secretion in stomach

Relieves symptoms associated with hyperacidity disorders

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16
Q

What are the indications for H2 antagonists?

A

GERD
PUD
Zollinger-Ellison syndrome

17
Q

What are the contraindications for H2 antagonists?

A

Allergy
Liver dysfunction
Kidney dysfunction

18
Q

What are examples of H2 antagonists?

A

Cimetidine (Tagamet)
Nizatidine (Axid)
Famotidine (Pepcid)
Ranitidine (Zantac)

19
Q

What are the adverse effects of H2 antagonists?

A

Low incidence of adverse effects

May cause some CNS effects in geriatric patients (lethargy, depression, confusion)

20
Q

What are the nursing implications for H2 antagonists?

A

Smoking reduces effectiveness

Take 1 hour before taking other medicaitons

21
Q

What is the mechanism of action of proton pump inhibitors?

A

Binds to the proton pump (hydrogen-potassium-ATPase), preventing movement of hydrogen ions out of parietal cell, blocking al gastric acid secretion

22
Q

What is the drug effect of proton pump inhibitors?

A

Reduces amount of gastric acid

23
Q

What are the indications for proton pump inhibitors?

A
GERD not responsive to H2 blockers
Erosive esophagitis
Active gastric/duodenal ulcers
Zollinger-Ellison syndrome
Stress ulcer prophylaxis
Treatment of H. pylori
24
Q

What are the contraindications of proton pump inhibitors?

25
What are some examples of proton pump inhibitors?
``` Lansoprazole (Prevacid) Omeprazole (Prilosec) Rabeprazole (Aciphex) Pantoprazole (Protonix) Exomeprazole (Nexium) ```
26
What are the adverse effects of proton pump inhibitors?
Generally well tolerated | Concerns of predisposing patients to GI tract infections
27
What are nursing implications for proton pump inhibitors?
Work best before breakfast Do not crush or chew sustained-release capsules Long-term use may increase risk of osteoporosis Notify provider for any signs of GI bleeding (coffee-grind emesis, tarry stool)
28
What are some miscellaneous acid-controlling drugs?
Sucralfate (Carafate) Misoprostol (Cytotec) Simethicone (Mylicon)
29
What are the indications for sucralfate (Carafate)?
Long-term therapy for PUD
30
What is the mechanism of action of sucralfate (Carafate)?
Binds directly to surface of ulcer and forms protective barrier
31
What are the indications for misoprostol (Cytotec)?
Gastric ulcers in patients taking NSAIDs
32
What is the class of misoprostol (Cytotec)?
Prostaglandin E analogue
33
What are the nursing implications for misoprostol (Cytotec)?
Pregnancy category X
34
What is the mechanism of action of simethicone (Mylicon)?
Alters the elasticity of mucus-coated gas bubbles, causing them to break down into smaller ones
35
What is the drug effect of simethicone (Mylicon)?
Reduce the discomforts of flatulence and aid in its release
36
What are the indications for simethicone (Mylicon)?
Pain associated with post-operative gaseous distention