Ch 55 Stomach Disorders

Question 1

Antacids increase pH of gastric contents by deactivating pepsin.

• you want to give 2 hr pc(after meals)and at bedtime
• do not give other drugs within 1-2 hrs of antacids
• assess pt for hx of renal disease. These antacids contain magnesium which cannot be excreted by poor function kidneys, thus cause toxicity

Answer 1

Magnesium hydroxide with aluminum hydroxide (Maalox, mylanta) 50-80 meq po pc and bedtime

Question 2

Antacids
Want to give this one hour pc and at bedtime
Observe for constipation
Do not give other drugs 1-2 hours of antacids
Aluminum causes constipation and magnesium causes diarrhea
Use this antacid for pt with renal failure
This antacid does not contain aluminum

Answer 2

Aluminum hydroxide (Amphojel)
50-80 mEq po 1hr and 3hr pc and at bedtime

Question 3

H2 antagonists (blockers)
These decrease gastric acid secretions by blocking histamine receptors in parietal cells
You want to give a single dose at bedtime for tx of GI ulcers, heartburn, and PUD
-the bedtime administration suppresses nocturnal acid production

Answer 3

Ranitidine (Zantac)
Famotidine (Pepcid)
Nizatidine (axid)

Question 4

Mucosal Barrier Fortifier

This one binds with bile acids and pepsin to protect stomach mucosa
Give one hr before and two hr after meals and at bedtime
Do not give within 30 min of giving antacids or other drugs

Answer 4

Sucralfate (Carafate) 1 G po qid or 2G po bid

Question 5

Mucosal Barrier Fortifier
This one stimulates mucosal protection and prostaglandin production.
Also inhibits H pylori from binding to mucosal lining
-do not take aspirin while taking this drug. OD of aspirin may occur
-may cause stools to be discolored black

Answer 5

Bismuth Subsalicylate (Pepto Bismol)
30 mL po qid

Question 6

Proton pump inhibitor’s
They inhibit gastric acid secretion
For short and long term use for PUD, heartburn, and H pylori treatment
Take whole capsule
Do not crush
Give 30 min before main meal of day
Proton pump is activated by presence of food

Answer 6

Omeprazole (Prilosec) 20-40 mg po daily

Lansoprazole (Prevacid)15-30 mg po daily

Question 7

This PPI is once daily pill given after morning meal

It promotes healing and symptom relief of duodenal ulcers

Answer 7

Rabeprazole (Aciphex) 20 mg po once daily

Question 8

This PPI may have several adverse drug interactions
Drug is enteric coated
IV form must be given on pump with filter and in a separate line

Answer 8

Pantoprazole (protonix) 40 mg po or IV daily for 7-10 days

Question 9

This PPI requires assessment for hepatic impairment
Patients with severe hepatic problems need a low dose
The IV form is not compatible with most other drugs
Alters how drugs are metabolized

Answer 9

Esomeprazole (nexium)
20 or 40 mg po daily
IV for 7-10 days

Question 10

Prostaglandin analogs

This drug is a synthetic prostaglandin that stimulates mucosal protection and decrease gastric acid secretions
Also helps resist mucosal injury in patients taking NSAIDs and or high dose corticosteroids
-avoid magnesium containing antacids
Do not use in pregnant women

Answer 10

Misoprostol (cytotec)

200 mcg po qid