10 Questions
What is the primary purpose of the pharmacological action described in the text?
To eradicate H. pylori bacteria
How long should the combination therapy, including two or three antibiotics, be administered?
14 days
Which of the following adverse effects is commonly associated with the medications described in the text?
Nausea and diarrhea
What is the recommended nursing action for the adverse effects of constipation, diarrhea, and nausea?
Report the effects to the provider
Which of the following groups of clients is more likely to experience adverse CNS effects from the medications?
Older adults with kidney or liver dysfunction
Why should H₂ receptor antagonists be used cautiously in clients at high risk for pneumonia, including those with COPD?
They can increase gastric acidity, which promotes bacterial colonization of the stomach and respiratory tract
What is the recommended nursing action for the adverse CNS effects, such as lethargy, hallucinations, confusion, and restlessness?
Report the effects to the provider
Why should metronidazole be administered with food?
To decrease the risk of gastric disturbances
How should the dosage of the medications be adjusted for clients with moderate to severe kidney impairment?
The dosage should be decreased to prevent accumulation of the medications
What is the recommended client education regarding the adverse effects of the medications?
The adverse effects will reverse when the dosing of the medications is stopped
Study Notes
Gastric Acid Reducers
- Block basal and nocturnal gastric acid secretion, reducing the production of gastric acid and alleviating symptoms of duodenal ulcers.
- Contraindications and precautions:
- Misoprostol: contraindicated in pregnancy and lactation
- Omeprazole: use with caution in pregnancy and lactation
- Pantoprazole: contraindicated in pregnancy and lactation
- Interactions:
- Digoxin and phenytoin levels may increase when used concurrently with omeprazole
- Ketoconazole, itraconazole, and atazanavir absorption decreased when taken concurrently with proton pump inhibitors
- Clopidogrel effects decreased when used concurrently with proton pump inhibitors
- Nursing actions:
- Monitor digoxin and phenytoin levels carefully
- Avoid concurrent use of ketoconazole, itraconazole, and atazanavir with proton pump inhibitors
- Monitor for thrombotic events with concurrent use of clopidogrel
- Administration:
- Do not crush, chew, or break sustained-release capsules
- Do not open capsule and sprinkle contents over food to facilitate swallowing
Mucosal Protectant
- Sucralfate:
- Forms a protective barrier on the ulcer, protecting it from acid and pepsin
- Minimal systemic absorption, mostly eliminated in feces
- Complications: constipation
- Contraindications and precautions:
- Hypersensitivity to the medication
- Client education:
- Increase dietary fiber and fluid intake to prevent constipation
Antacids
- Neutralize or reduce gastric acid, can reduce pepsin activity
- Therapeutic uses:
- Treatment of peptic ulcer disease
- Prevention of stress-induced ulcers
- Relief of GERD symptoms
- Complications:
- Constipation (aluminum compounds)
- Diarrhea (magnesium compounds)
- Fluid retention (sodium-containing antacids)
- Electrolyte imbalances (aluminum and calcium compounds)
- Client education:
- Alternate use of antacids to offset intestinal effects
- Avoid antacids containing sodium if hypertensive or heart failure
- Report manifestations of hypercalcemia
- Contraindications and precautions:
- Use with caution in clients with abdominal pain, GI perforation, or obstruction
- Interactions:
- Antacids decrease absorption of several medications, including famotidine and cimetidine
- Aluminum compounds bind to warfarin, digoxin, and tetracycline, reducing their effects
- Nursing administration:
- Administer frequently (up to 7 times a day)
- Encourage compliance by reinforcing the intended effect of the antacid
Eradication of H. pylori
- Purpose: eradication of H. pylori bacteria
- Therapeutic uses:
- Combination therapy with antibiotics for 14 days
- Nursing administration:
- Administer metronidazole with food to decrease gastric disturbances
- Client education:
- Take the full course of prescribed medications
- Adverse effects reverse when dosing stops
- Contraindications and precautions:
- Use with caution in pregnancy and lactation
- Older adults may experience adverse CNS effects and may require decreased dosage
Test your knowledge on drug interactions and contraindications with this quiz focusing on the usage of Sharpe HIGHLIGHTER GUARD POSE AL ACTION for blocking basal gastric acid production. Learn about precautions, contraindications, and potential risks associated with the drug treatment.
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