Peptic Ulcer Disease

Question 1

Peptic Ulcer Disease

medications used

Answer 1

-group of upper GI problems caused by erosion of gut wall
Medications:
-antibiotics
-antisecretory agents
-mucosal protectants
-antacids

Question 2

Peptic Ulcer Disease

Antibiotics: prototypes

Answer 2

1) amoxicillin (Amoxil)
2) bismuth (Pepto-Bismol)
3) clarithromycin (Biaxin)
4) metronidazole (Flagyl)
5) tetracycline (Achromycin V)

Question 3

Peptic Ulcer Disease
Antibiotics
expected action and therapy

Answer 3

1) eradication of H. pylori bacteria

2) combination of 2 or 3 antibiotics for 14 days

Question 4

Peptic Ulcer Disease
Histamine 2 Receptor Antagonists
Medications

Answer 4

1) prototype = ranitidine hydrochloride (Zantac)
2) other medications =
- cimetidine (Tagamet)
- nizatidine (Axid)
- famotidine (Pepcid)

Question 5

Peptic Ulcer Disease
Histamine 2 Receptor Antagonists
expected action and therapeutic uses

Answer 5

1) suppress secretion of gastric acid
2) -gastric and peptic ulcers
- gastroesophageal reflux disease
- H. pylori

Question 6

Histamine 2 Receptor Antagonists

adverse effects

Answer 6

1) cimetidine may cause decreased libido, impotence
2) CNS effects
- lethargy
- depression
- confusion

Question 7

Histamine 2 Receptor Antagonists

nursing interventions/client education

Answer 7

1) instruct clients of possible adverse effects

2) avoid cimetidine in older adults

Question 8

Histamine 2 Receptor Antagonists

Interactions

Answer 8

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

Question 9

Histamine 2 Receptor Antagonists

Nursing Administration

Answer 9

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

Question 10

Proton Pump Inhibitor

medications

Answer 10

1) prototype = omeprazole (Prilosec)
2) other medications =
- pantoprazole (Protonix)
- lansoprazole (Prevacid)
- rabeprazole sodium (AcipHex)
- esomeprazole (Nexium)

Question 11

Proton Pump Inhibitor

expected action and therapeutic uses

Answer 11

1) inhibit enzyme that produces gastric acid
2) -ulcers
- GERD
- Zollinger-Ellison syndrome

Question 12

Proton Pump Inhibitor

medication/food interactions

Answer 12

1) digoxin (lanoxin) levels will be increased

2) absorption of ketocanazole is decreased when taken together

Question 13

Proton Pump Inhibitor

nursing interventions/client education

Answer 13

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

Question 14

Mucosal Protectant:

medications

Answer 14

prototype = sucralfate (Carafate)

Question 15

Mucosal Protectant:

expected action and therapeutic actions

Answer 15

1) -environment of stomach and duodenum cause sucralfate into thick substance
- adheres to ulcer, protecting it
2) -gastric ulcers
- gastroesophageal reflux disease

Question 16

Sucralfate

Answer 16

• will cause constipation
• increase dietary fiber
• drink at least 1,500 mL/day if fluids not restricted

Question 17

Sucralfate:

interactions

Answer 17

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

Question 18

Sucralfate:

client education

Answer 18

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

Question 19

Antacids:

medications

Answer 19

1) prototype = aluminum hydroxide (Amphojel)
2) other medications =
- aluminum carbonate
- magnesium hydroxide (Milk of Magnesia)
- sodium bicarbonate

Question 20

Antacids:

purpose and therapeutic uses

Answer 20

1) -neutralize gastric acid
- inactivate pepsin
- mucosal protection
2) -peptic ulcer disease
- relief from GERD

Question 21

Antacids:

adverse effects

Answer 21

1) constipation:
- aluminum
- calcium
2) diarrhea
- magnesium
3) fluid retention
- antacids
4) hypophosphatemia
- aluminum hydroxide
5) renal impairment
- magnesium

Question 22

Antacids:

nursing interventions/client education

Answer 22

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

Question 23

Antacids:

nursing administration

Answer 23

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

Question 24

Prostaglandin E Analog: medication

Answer 24

prototype = misoprostol (Cytotec)

Question 25

Prostaglandin E Analog: expected action and therapeutic uses

Answer 25

1) prevent gastric ulcers
2) -use w/ long-term NSAIDS to prevent gastric ulcers
- induce labor by causing cervical ripening

Question 26

Prostaglandin:

adverse effects

Answer 26

1) diarrhea
2) abdominal pain
3) women may experience dysmenorrhea and spotting

Question 27

Prostaglandin:

nursing interventions and client education

Answer 27

1) notify provider of manifestations

2) take w/ meals and at bedtime