Acid-Controlling Drugs Flashcards
What are the classes of acid-controlling drugs?
Antacids
Histamine (H2) antagonists
Proton pump inhibitors (PPI)
What is the mechanism of action of antacids?
Increases gastric pH to neutralize gastric acidity
Antacids DO NOT prevent overproduction of acid
What is the drug effect of antacids?
Reduction of pain associated with acid-related disorders (heartburn)
What are the indications for antacids?
Symptoms associated with: PUD Gastritis Heartburn Hyperacidity
What are the contraindications for antacids?
Allergy
Renal failure
Electrolyte disturbances
Gastrointestinal obstruction
What are examples of magnesium-containing antacids?
Gaviscon liquid
Milk of magnesium
What are examples of aluminum-containing antacids?
Amphogel
What are examples of magnesium and aluminum combo antacids?
Maalox
Mylanta
What are examples of sodium-containing antacids?
Alka-seltzer
What are examples of calcium-containing antacids?
Tums
What are the adverse effects of antacids?
Magnesium - diarrhea
Aluminum and calcium - constipation
Calcium - kidney stones
Sodium bicarbonate - alkalosis
What are the interactions concerning antacids?
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
What are nursing implications for antacids?
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
What is the mechanism of action of H2 antagonists?
Block histamine at H2 receptors of acid-producing parietal cells, reducing production of hydrogen ions, resulting in decreased production of HCl
What is the drug effect of H2 antagonists?
Suppresses acid secretion in stomach
Relieves symptoms associated with hyperacidity disorders
What are the indications for H2 antagonists?
GERD
PUD
Zollinger-Ellison syndrome
What are the contraindications for H2 antagonists?
Allergy
Liver dysfunction
Kidney dysfunction
What are examples of H2 antagonists?
Cimetidine (Tagamet)
Nizatidine (Axid)
Famotidine (Pepcid)
Ranitidine (Zantac)
What are the adverse effects of H2 antagonists?
Low incidence of adverse effects
May cause some CNS effects in geriatric patients (lethargy, depression, confusion)
What are the nursing implications for H2 antagonists?
Smoking reduces effectiveness
Take 1 hour before taking other medicaitons
What is the mechanism of action of proton pump inhibitors?
Binds to the proton pump (hydrogen-potassium-ATPase), preventing movement of hydrogen ions out of parietal cell, blocking al gastric acid secretion
What is the drug effect of proton pump inhibitors?
Reduces amount of gastric acid
What are the indications for proton pump inhibitors?
GERD not responsive to H2 blockers Erosive esophagitis Active gastric/duodenal ulcers Zollinger-Ellison syndrome Stress ulcer prophylaxis Treatment of H. pylori
What are the contraindications of proton pump inhibitors?
Allergy
What are some examples of proton pump inhibitors?
Lansoprazole (Prevacid) Omeprazole (Prilosec) Rabeprazole (Aciphex) Pantoprazole (Protonix) Exomeprazole (Nexium)
What are the adverse effects of proton pump inhibitors?
Generally well tolerated
Concerns of predisposing patients to GI tract infections
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)
What are some miscellaneous acid-controlling drugs?
Sucralfate (Carafate)
Misoprostol (Cytotec)
Simethicone (Mylicon)
What are the indications for sucralfate (Carafate)?
Long-term therapy for PUD
What is the mechanism of action of sucralfate (Carafate)?
Binds directly to surface of ulcer and forms protective barrier
What are the indications for misoprostol (Cytotec)?
Gastric ulcers in patients taking NSAIDs
What is the class of misoprostol (Cytotec)?
Prostaglandin E analogue
What are the nursing implications for misoprostol (Cytotec)?
Pregnancy category X
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
What is the drug effect of simethicone (Mylicon)?
Reduce the discomforts of flatulence and aid in its release
What are the indications for simethicone (Mylicon)?
Pain associated with post-operative gaseous distention
