Final Study Guide NR565

Exam Final Study Guide NR565 Week 7 & 8  Antacids: weak bases that react with hydrochloric acid to form salt & water. -Neutralize Gastric Acidity (causes ^pH of the stomach and duodenal bulb) -Inhibit proteolytic activity of pepsin -Increase lower esophageal sphincter tone -ALL antacids are contraindicated in the presence of severe abdominal pain of unknown cause, especially if accompanied by fever -HIGH SODIUM content: pts w/ HTN. CHF need to use low sodium preparation -Concurrent administration with enteric-coated drugs, destroys the coating= alters absorption, ^ the risk for adverse effects -Administrations should be separated by at least 2 hours to decrease interactions 1. Calcium based antacids: TUMS, Caltrate, Calcarb  Require Vitamin D for absorption from the GI tract  Prescribed to treat calcium deficient states, i.e. chronic renal failure, post-menopause, and osteoporosis  Contraindicated in the presence of hypercalcemia and renal calculi  Can cause constipation- increase bulk, fluids and mobility, stool softener  Administered 30min- 1hr on empty stomach or 3hr after meals  Should not be administered with food containing large amounts of oxalic acid (spinach, rhubarb), or phytic acid (bran, cereals), they decrease the absorption of calcium  Taking w/ foods containing phosphorus (milk, dairy) can lead to milk-alkali syndrome (N/V, confusion, headache).  Taking with acidic fruit juice improve absorption 2. Aluminum based: AlternaGEL, Amphojel, Mylanta  Inhibit smooth muscle contraction and slow gastric emptying  Aluminum concentrated in the CNS  Prolonged use in patients with renal failure may result in dialysis osteomalacia  Elevated aluminum tissues levels contribute to the development of dialysis encephalopathy  Used to treat hyperphosphatemia in pts w/ renal failure & phosphate renal stone prevention  Can cause constipation- increase bulk, fluids and mobility, stool softener