PUD/GERD meds Flashcards
Proton Pump inhibitor drugs
“Zoles’s”
Esomeprazole (Nexium)
Lansoprazole (Prevacid)
Pantoprazole (Protonix)
Esomeprazole (Nexium)
Lansoprazole (Prevacid)
Pantoprazole (Protonix)
Indiction:
PUD and GERD
-Working with 2 antibiotics to treat H. Pylori
MOA of Zoles
Reduces acid secretion in stomach by binding irreversibly to the enzyme of Na+K+ ATPase Pump
Pump secretes acid, and PPIs inhibit the final pathway of acid secretion by blocking it
Adverse effects of Zoles
Esomeprazole (Nexium)
Lansoprazole (Prevacid)
Pantoprazole (Protonix)
CNS
- headache
- dizziness
GI
- flatulence
- N/V/D
Nursing Concerns for Zoles
Esomeprazole (Nexium)
Lansoprazole (Prevacid)
Pantoprazole (Protonix)
- Take 20-30 min before first meal (proton pump activated by food)
- Short half life (about 1.5 hr) but suppress acid for 24 hrs (irreversible)
- 4 days to achieve maximal effects (not all pump inactivated by first dose)
- Food intake with beneficial bacteria/normal flora like yogurt
- Keep head of bed elevated 30 degrees if you experience heartburn
- DO NOT crush, break or chew tablets/capsule
Assessment for Patients taking Zoles
- Complete medical history, allergies and drug interactions
- Routine liver function tests for prolong use. Interactions
- Vit B12 & Folic Acid can cause malabsorption, Avoid smoking, EtOH, and breastfeeding
Histamine 2 Antagonist
“Dines”
Ranitidine (Zantac)
Cimetidine (Tagamet)
Famotidine (Pepcid)
"Dines" Ranitidine (Zantac) Cimetidine (Tagamet) Famotidine (Pepcid) are for?
PUD and GERD
MOA for “Dines”
Ranitidine (Zantac)
Cimetidine (Tagamet)
Famotidine (Pepcid)
- Block H2 Receptors on parietal cells in stomach to decrease acid production
- Suppress day time/nocturnal basal gastric acids
Adverse effects for "Dines" Ranitidine (Zantac) Cimetidine (Tagamet) Famotidine (Pepcid)
*Strong Effects on elderly and those with Renal Disease CNS: Confusion Restlessness Hallucinations Depression GI: Elevated Liver Enzymes N/V/D CV: Arrhythmias
Nursing Concerns for "Dines" Ranitidine (Zantac) Cimetidine (Tagamet) Famotidine (Pepcid)
- Rapid absorption from small intestine (30 min onset of action)
- Short half-life/rapid excretion (from 1 to 4 hr)
- No known effects on the fetus
Interactions with "Dines" Ranitidine (Zantac) Cimetidine (Tagamet) Famotidine (Pepcid)
- DO NOT take with Antacids→ diminished absorption
- DO NOT confuse with H2 Antagonists (Benadryl against allergic rhinitis)
Antacids
Aluminum Hydroxide (AlternaGel)
Aluminum Hydroxide (AlternaGel) is used for?
PUD and GERD
also treats symptoms of heartburn
MOA for Aluminum Hydroxide (AlternaGel)
- Alkaline Substance that neutralizes stomach acid to bring the pH above 3 and inactivates pepsin
- Most isn’t absorbed; Works directly on stomach acid and is secreted in the feces