Peptic Ulcer Disease Flashcards
Peptic Ulcer Disease
medications used
-group of upper GI problems caused by erosion of gut wall Medications: -antibiotics -antisecretory agents -mucosal protectants -antacids
Peptic Ulcer Disease
Antibiotics: prototypes
1) amoxicillin (Amoxil)
2) bismuth (Pepto-Bismol)
3) clarithromycin (Biaxin)
4) metronidazole (Flagyl)
5) tetracycline (Achromycin V)
Peptic Ulcer Disease
Antibiotics
expected action and therapy
1) eradication of H. pylori bacteria
2) combination of 2 or 3 antibiotics for 14 days
Peptic Ulcer Disease
Histamine 2 Receptor Antagonists
Medications
1) prototype = ranitidine hydrochloride (Zantac)
2) other medications =
- cimetidine (Tagamet)
- nizatidine (Axid)
- famotidine (Pepcid)
Peptic Ulcer Disease
Histamine 2 Receptor Antagonists
expected action and therapeutic uses
1) suppress secretion of gastric acid
2) -gastric and peptic ulcers
- gastroesophageal reflux disease
- H. pylori
Histamine 2 Receptor Antagonists
adverse effects
1) cimetidine may cause decreased libido, impotence
2) CNS effects
- lethargy
- depression
- confusion
Histamine 2 Receptor Antagonists
nursing interventions/client education
1) instruct clients of possible adverse effects
2) avoid cimetidine in older adults
Histamine 2 Receptor Antagonists
Interactions
1) cimetidine can increase levels of:
- warfarin
- phenytoin
- theophylline
- lidocaine
2) antacids can decrease absorption of medications
3) monitor for bleeding
4) monitor PT, INR
5) monitor serum phenytoin, theophylline, lidocaine levels
6) take antacid 1 hr before or after
Histamine 2 Receptor Antagonists
Nursing Administration
1) drugs given IV:
- cimetidine (Tagamet)
- ranitidine (Zantac)
- famotidine (Pepcid)
2) client education:
- eat 6 small meals a day
- get adequate rest
- reduce stress
- avoid smoking
- avoid aspirin
- avoid alcohol
- medication regimen may be complex
- adhere to regimen
- ranitidine (Zantac) can be taken with food
Proton Pump Inhibitor
medications
1) prototype = omeprazole (Prilosec)
2) other medications =
- pantoprazole (Protonix)
- lansoprazole (Prevacid)
- rabeprazole sodium (AcipHex)
- esomeprazole (Nexium)
Proton Pump Inhibitor
expected action and therapeutic uses
1) inhibit enzyme that produces gastric acid
2) -ulcers
- GERD
- Zollinger-Ellison syndrome
Proton Pump Inhibitor
medication/food interactions
1) digoxin (lanoxin) levels will be increased
2) absorption of ketocanazole is decreased when taken together
Proton Pump Inhibitor
nursing interventions/client education
1) monitor digoxin level if prescribed concurrently
2) avoid concurrent use
3) do not chew, crush, or break SR capsules
4) can sprinkle contents of capsule over food to help in swallowing
5) take omeprazole (Prilosec) daily in am
6) avoid alcohol and NSAIDS
7) 4-6 wks for treatment of active ulcers
Mucosal Protectant:
medications
prototype = sucralfate (Carafate)
Mucosal Protectant:
expected action and therapeutic actions
1) -environment of stomach and duodenum cause sucralfate into thick substance
- adheres to ulcer, protecting it
2) -gastric ulcers
- gastroesophageal reflux disease
Sucralfate
- will cause constipation
- increase dietary fiber
- drink at least 1,500 mL/day if fluids not restricted
Sucralfate:
interactions
1) interferes with absorption of many medications:
- phenytoin
- digoxin
- warfarin
- cipro
- antacids
2) maintain 2 hr interval between medications
3) do not administer antacids within 30 min of sucralfate
Sucralfate:
client education
1) instruct on medication regimen
2) take medication on empty stomach
3) take 4x a day, 1 hr before meals, bedtime
4) do not crush, chew, break or dissolve medicaiton
5) complete full course of treatment
Antacids:
medications
1) prototype = aluminum hydroxide (Amphojel)
2) other medications =
- aluminum carbonate
- magnesium hydroxide (Milk of Magnesia)
- sodium bicarbonate
Antacids:
purpose and therapeutic uses
1) -neutralize gastric acid
- inactivate pepsin
- mucosal protection
2) -peptic ulcer disease
- relief from GERD
Antacids:
adverse effects
1) constipation:
- aluminum
- calcium
2) diarrhea
- magnesium
3) fluid retention
- antacids
4) hypophosphatemia
- aluminum hydroxide
5) renal impairment
- magnesium
Antacids:
nursing interventions/client education
1) monitor for GI problems
2) instruct clients with hypertension or heart failure to avoid antacids
3) monitor phosphate level
4) clients who have renal impairment should avoid magnesium
Antacids:
nursing administration
1) chew tablets thoroughly
2) drink 8 oz water w/ tablet
3) shake liquid formulations
4) take all medications 1 hr before and after taking antacid
Prostaglandin E Analog: medication
prototype = misoprostol (Cytotec)
Prostaglandin E Analog: expected action and therapeutic uses
1) prevent gastric ulcers
2) -use w/ long-term NSAIDS to prevent gastric ulcers
- induce labor by causing cervical ripening
Prostaglandin:
adverse effects
1) diarrhea
2) abdominal pain
3) women may experience dysmenorrhea and spotting
Prostaglandin:
nursing interventions and client education
1) notify provider of manifestations
2) take w/ meals and at bedtime
