NUR3128 Exam 2 Drugs Study Guide.

NUR3128 Exam 2 Drugs Study Guide. Aluminum hydroxide (AlternaGEL) Therapeutic class - answerantiheartburn drug Aluminum hydroxide (AlternaGEL) Pharmacologic class - answerantacid Aluminum hydroxide Actions and Uses - answer-Aluminum compounds are minimally absorbed -Neutralize stomach acid by raising pH of stomach contents -Do not reduce volume of acid secretion -Most effectively used in combination with other antinuclear drugs for symptomatic relief of heartburn due to PUD or GERD Aluminum hydroxide Administration - answer· Administer 2 hours or more before or after other drugs · Can impact the absorption of other drugs · Pregnancy category C Aluminum hydroxide (AlternaGEL) Pregnancy category - answerC Aluminum hydroxide (AlternaGEL) Onset - answer20-40 min Aluminum hydroxide (AlternaGEL) Duration - answer2-3 hr Aluminum hydroxide (AlternaGEL) Adverse Effects - answer· Constipation · Phosphate depletion Aluminum hydroxide (AlternaGEL) Contraindications - answer· Patients with suspected bowel obstruction · Caution in patients who are malnourished, alcoholics, and who have CKD Aluminum hydroxide Drug to drug interactions - answerimpacts absorption of other drugs, sodium polystyrene sulfonate may cause systemic alkalosis Aluminum hydroxide (AlternaGEL) Lab test interactions - answerserum gastrin and urinary pH may increase, phosphate may decrease Aluminum hydroxide (AlternaGEL) Herbal/food interactions - answermay inhibit absorption of dietary iron Omeprazole (Prilosec) Therapeutic class - answerAntiulcer drug Omeprazole (Prilosec) Pharmacologic class - answerproton pump inhibitor Omeprazole (Prilosec) Actions and Uses - answer- First PPI to be approved for PUD - Available in Rx and OTC form - Reduces stomach acid secretion by creating an irreversible bind to the enzyme H+, K+ - ATPase - Used at higher dose and longer period for chronic hypersecretion of gastric acid (Zollinger- Ellison syndrome) - Zegerid: combo drug w/ omeprazole and sodium bicarb Omeprazole (Prilosec) Administration - answer- PO only; approved for children age 2 and older - Administer before breakfast, on empty stomach - May be administered w/ antacids - Capsules and tablets should not be chewed, divided or crushed Omeprazole (Prilosec) Pregnancy category - answerPregnancy Category C Omeprazole (Prilosec) Onset - answer1 hr, Can take 2hrs to reach therapeutic effect, Omeprazole (Prilosec) Duration - answer- effects last up to 72hrs - Used for 4-8 week therapy of active peptic ulcers and GERD; most patients are symptom free after 2 weeks Omeprazole (Prilosec) Adverse Effects - answer- Generally minor; headache, nausea, diarrhea, abdominal pain - Rare: blood disorders causing fatigue and weakness - Therapy is usually limited to 2 months; atrophic gastritis & hypomagnesemia have been reported with prolonged treatment Omeprazole (Prilosec) Contraindications - answer- Hypersensitivity to PPI - OTC not approved for under 18 years old Omeprazole (Prilosec) Drug to drug interactions - answerPPI lowers levels of erlotinib, nelfinavir, rilpivirine. Use w/ diazepam, phenytoin & CNS depressants may cause increase blood levels of those drugs. Use w/ warfarin may increase likelihood of bleeding. PPIs increase gastric pH and have potential to affect drugs that rely on low pH (ampicillin, atazanavir, digoxin, iron salts, azole antifungals) Omeprazole (Prilosec) Lab test interactions - answerMay increase ALT, AST and serum alkaline phosphatase Omeprazole (Prilosec) Herbal/food interactions - answerGinkgo & St. John's Wort may decrease plasma concentration of omeprazole Ranitidine (Zantac) Therapeutic class - answerAntiulcer drug Ranitidine (Zantac) Pharmacologic class - answerH2 receptor antagonist Ranitidine (Zantac) Actions and Uses - answer- Blocks H2 receptors in the stomach to decrease acid production - Higher potency than cimetidine, allows once daily administration, usually at bedtime - Adequate ulcer healing takes 4-8 weeks; those at high risk for PUD may continue drug maintenance to prevent recurrence - Also indicated for Zollinger-Ellison syndrome & erosive esophagitis Ranitidine (Zantac) Administration - answer- Administer after meals - Monitor liver & kidney function - IV and IM forms available to treat acute, stress-induced bleeding ulcers - Tritec: combo drug w/ ranitidine & bismuth citrate - Available in dissolving tablet for treating GERD in children under 1 month Ranitidine (Zantac) Pregnancy category - answerB Ranitidine (Zantac) Onset - answer30-60 min Ranitidine (Zantac) Duration - answer6-12 hrs Ranitidine (Zantac) Adverse Effects - answer- Headache is most common - Does not cross blood-brain barrier (no confusion or CNS depression that is seen w/ cimetidine) - Rare: severe reduction in RBCs, WBCs & platelets - High doses may result in impotence or loss