Gastrointestinal System and Nutrition • Peptic Ulcer Disease
Management of peptic ulcer diseases addresses the imbalance between gastric mucosal defenses and other factors such as H. Pylori, gastric acid, smoking, and NSAID use. However, when you reduce gastric acid your stomach becomes basic which is a good
breeding ground for bacteria. A natural defense mechanism for gastric acid entering the lungs during sleep is cilia.
Class Name Purpose Administration Complications Contraindications/
Precautions/ Interactions/ Extra
Antibiotic Amoxicillin Kill H. Pylori bacteria To treat H. Pylori, give at least two
Bismuth antibiotics
Histamine2- Cimetidine Block H2 receptors which •Eat meals on a regular schedule •Blocked androgen receptors (↓libido, •Can increase levels of coumadin (monitor
receptor reduces the volume of gastric •decrease gastric acidity, which gynecomastia, impotence) for bleeding, INR and PT levels)
antagonist acid promotes bacterial colonization •CNS effect (lethargy, depression, •Can increase levels of phenytoin,
of the stomach and the confusion) theophylline, and lidocaine (monitor serum
Ranitidine For GERD and H. Pylori GI (constipation or diarrhea, nausea)
[-tidine] respiratory tract. Use cautiously levels)
(Zantac)
Famotidine in clients who are at a high risk •Dizziness, drowsiness, constipation •no antacids 1hr before or after, no aspirin,
(Pepcid) for pneumonia, including clients no alcohol, reduce stress
who have chronic obstructive •Avoid foods that promote gastric secretion
pulmonary disease (COPD). and overeating
Proton Pump Pantoprazole •Inhibit the enzyme that •Headache (IV), diarrhea, nausea, •Excess PPI can cause C.Dif
Inhibitor (Protonix) produces gastric acid vomiting, thrombophlebitis •Can increase risk of pneumonia
Omeprazole •for ulcers and GERD •Osteoporosis and fractures (long •with Omeprazole monitor with digoxin,
[-prazole] Lansoprazole termuse) phenytoin, coumadin
Esomeprazole •Rebound acid hypersecretion (taper
slowly when discontinuing to prevent)
Mucosal Sucralfate Protects the ulcer from further Give 1hr before meals and at •Constipation (increase fiber, water •coumadin and tetracycline need to be 1hr
,protectant (Carafate) injury by creating a protective bedtime intake at least 1500 ml/day) apart
barrier/coating
, Antacids Aluminum Neutralize gastric acid •Give 1hr and 3hrs after meal •Constipation
Hydroxide and at bedtime •Hypophosphatemia (monitor urine
•Pt should take all medications output)
1hr before or after taking •Hypomagnesemia (monitor for ↑
antacids deep tendon reflexes)
Magnesium •Hyperphosphatemia (monitor urine
•take with 8oz of water or milk
Hydroxide output)
(MOM) •Diarrhea (laxative)
•Toxicity, hypermagnesemia (in
impaired kidney pts)
Calcium •Hypercalcemia (muscles flaccid,
Carbonate (Tums) increased HR the decreased HR)
Constipation
Prostaglandin E Misoprostol •1) Decreases acid secretion •2) •begin on day 2-3 of menstrual •Diarrhea •Pregnancy Risk X
analog increases the secretion of bicarb cycle •Dysmenorrhea, spotting •check for pregnancy
and 3) protective mucosal layer •can be given during labor to open the
•4) promotes vasodilation to cervix
maintain blood flow and
increase healing
• Gastrointestinal Disorders •
Management of nausea, vomiting, motion sickness, diarrhea, constipation, GERD by increasing gastric motility, protecting stomach lining, and inhibiting secretion of gastric acid.
Class Name Purpose Administration Complications Contraindications/
Precautions/ Interactions/ Extra
Antiemetics Glucocorticoids: Mechanism unknown • For chemotherapy induced N/V •Risk for infection, hyperglycemia fluid
Dexamathasone give glucocorticoid and at least 2 retention, weight gain, osteoporosis,
Management of peptic ulcer diseases addresses the imbalance between gastric mucosal defenses and other factors such as H. Pylori, gastric acid, smoking, and NSAID use. However, when you reduce gastric acid your stomach becomes basic which is a good
breeding ground for bacteria. A natural defense mechanism for gastric acid entering the lungs during sleep is cilia.
Class Name Purpose Administration Complications Contraindications/
Precautions/ Interactions/ Extra
Antibiotic Amoxicillin Kill H. Pylori bacteria To treat H. Pylori, give at least two
Bismuth antibiotics
Histamine2- Cimetidine Block H2 receptors which •Eat meals on a regular schedule •Blocked androgen receptors (↓libido, •Can increase levels of coumadin (monitor
receptor reduces the volume of gastric •decrease gastric acidity, which gynecomastia, impotence) for bleeding, INR and PT levels)
antagonist acid promotes bacterial colonization •CNS effect (lethargy, depression, •Can increase levels of phenytoin,
of the stomach and the confusion) theophylline, and lidocaine (monitor serum
Ranitidine For GERD and H. Pylori GI (constipation or diarrhea, nausea)
[-tidine] respiratory tract. Use cautiously levels)
(Zantac)
Famotidine in clients who are at a high risk •Dizziness, drowsiness, constipation •no antacids 1hr before or after, no aspirin,
(Pepcid) for pneumonia, including clients no alcohol, reduce stress
who have chronic obstructive •Avoid foods that promote gastric secretion
pulmonary disease (COPD). and overeating
Proton Pump Pantoprazole •Inhibit the enzyme that •Headache (IV), diarrhea, nausea, •Excess PPI can cause C.Dif
Inhibitor (Protonix) produces gastric acid vomiting, thrombophlebitis •Can increase risk of pneumonia
Omeprazole •for ulcers and GERD •Osteoporosis and fractures (long •with Omeprazole monitor with digoxin,
[-prazole] Lansoprazole termuse) phenytoin, coumadin
Esomeprazole •Rebound acid hypersecretion (taper
slowly when discontinuing to prevent)
Mucosal Sucralfate Protects the ulcer from further Give 1hr before meals and at •Constipation (increase fiber, water •coumadin and tetracycline need to be 1hr
,protectant (Carafate) injury by creating a protective bedtime intake at least 1500 ml/day) apart
barrier/coating
, Antacids Aluminum Neutralize gastric acid •Give 1hr and 3hrs after meal •Constipation
Hydroxide and at bedtime •Hypophosphatemia (monitor urine
•Pt should take all medications output)
1hr before or after taking •Hypomagnesemia (monitor for ↑
antacids deep tendon reflexes)
Magnesium •Hyperphosphatemia (monitor urine
•take with 8oz of water or milk
Hydroxide output)
(MOM) •Diarrhea (laxative)
•Toxicity, hypermagnesemia (in
impaired kidney pts)
Calcium •Hypercalcemia (muscles flaccid,
Carbonate (Tums) increased HR the decreased HR)
Constipation
Prostaglandin E Misoprostol •1) Decreases acid secretion •2) •begin on day 2-3 of menstrual •Diarrhea •Pregnancy Risk X
analog increases the secretion of bicarb cycle •Dysmenorrhea, spotting •check for pregnancy
and 3) protective mucosal layer •can be given during labor to open the
•4) promotes vasodilation to cervix
maintain blood flow and
increase healing
• Gastrointestinal Disorders •
Management of nausea, vomiting, motion sickness, diarrhea, constipation, GERD by increasing gastric motility, protecting stomach lining, and inhibiting secretion of gastric acid.
Class Name Purpose Administration Complications Contraindications/
Precautions/ Interactions/ Extra
Antiemetics Glucocorticoids: Mechanism unknown • For chemotherapy induced N/V •Risk for infection, hyperglycemia fluid
Dexamathasone give glucocorticoid and at least 2 retention, weight gain, osteoporosis,
