| Drug and Dosage | Use | Action | Assessment: Side Effects |
|---|---|---|---|
| Aluminum hydroxide gel (Amphojel)—PO 5–10 mL q2–4h or 1 hr pc | Gastric acidity; peptic ulcer; phosphatic urinary calculi; ↓ phosphorus level in chronic renal failure | Buffers HCl in gastric juices without interfering with electrolyte balance | Constipation and fecal impaction |
| NURSING IMPLICATIONS: Shake well before administering; encourage fluids to prevent impaction and milk-alkali syndrome | |||
| Calcium carbonate (Titralac)—PO 1–2 gm taken with H2O after meals and at bedtime | Peptic ulcer and chronic gastritis | Reduces hyperacidity | Constipation or laxative effect |
| NURSING IMPLICATIONS: See Aluminum hydroxide gel | |||
| Cimetidine (Tagamet)—PO 300–600 mg q6h; IM, IV 300 mg q6h | Duodenal ulcers, gastroesophageal reflux disease (GERD), gastric hypersecretion; peptic acid gastritis, heartburn; esophagitis | Inhibits action of histamine at H2 receptor site, inhibits gastric acid secretion; neutralizes and absorbs excess acid | Confusion, dizziness; nausea; rash; diarrhea, constipation; hypermagnesemia |
| NURSING IMPLICATIONS: Give with meals or immediately after; avoid smoking; avoid prolonged administration to clients with renal insufficiency | |||
| Famotidine (Pepcid)—PO 40 mg/day at bedtime or 20 mg twice a day | Peptic ulcer | Inhibits gastric acid secretion by inhibiting histamine at H2 receptor site | Use with caution: elderly, renal failure; confusion, arrhythmias, agranulocytosis, aplastic anemia |
| NURSING IMPLICATIONS: Assess for: epigastric pain, blood in stool, or emesis; monitor laboratory values to avoid side effects; take medication for full course of treatment; avoid self-medication with OTC drugs; avoid smoking | |||
| Lansoprazole (Prevacid)—PO 15 mg/day; with Helicobacter pylori: 30 mg twice a day with amoxicillin | Peptic ulcer | Binds to an enzyme in presence of gastric acid; prevents final transport of hydrogen ions into gastric lumen | Hypersensitivity; use with caution in elderly; dosage change needed with hepatic impairment |
| NURSING IMPLICATIONS: Avoid alcohol; report signs of: GI bleeding, cramping, abdominal pain, vomiting | |||
| Magnesium and aluminum hydroxides (Maalox suspension)—PO 5–30 mL q1–3h pc and at bedtime | Gastric hyperacidity; peptic ulcer; heartburn; reflux esophagitis | Neutralizes and binds gastric acids, heals ulcers | Constipation from aluminum hydroxide; diarrhea from magnesium hydroxide |
| NURSING IMPLICATIONS: Encourage fluid intake; contraindicated for clients who are debilitated or those with renal insufficiency | |||
| Misoprostol (Cytotec)—PO 200 mcg 4 times/day; rectal 800 mcg; vaginal 25–50 mcg | Peptic ulcer Obstetric use: labor induction, to control postpartum hemorrhage | Prostaglandin analogue | Hypersensitivity to prostaglandins; diarrhea; avoid during pregnancy |
| NURSING IMPLICATIONS: Monitor effectiveness of the drug; report increase in abdominal pain, bleeding | |||
| Nizatidine (Axid) see Cimetidine | See Cimetidine | See Cimetidine | See Cimetidine |
| NURSING IMPLICATIONS: See Cimetidine | |||
| Omeprazole (Prilosec)—PO 20 mg once daily | Peptic ulcer GERD | Gastric acid–pump inhibitor | Abdominal pain; contraindicated: hypersensitivity |
| NURSING IMPLICATIONS: May cause drowsiness, dizziness; avoid: alcohol, aspirin, NSAIDs, foods that cause GI irritation | |||
| Ranitidine (Zantac)—PO 150 mg twice daily; IM 50 mg q6–8h; IV 50 mg q6–8h | Duodenal ulcer, gastric ulcer, GERD, gastric hypersecretion | Inhibits action of histamine at H2 receptor site, inhibits gastric acid secretion | Headache, malaise; nausea, constipation, diarrhea |
| NURSING IMPLICATIONS: Food does not affect absorption; give 1 hr apart from antacids; smoking interferes with action | |||
| Sucralfate (Carafate)—PO 1 gm 4 times daily | Prevention and treatment of duodenal ulcer | Reacts with gastric acid to form a thick paste that adheres to the ulcer surface | Constipation |
 NURSING IMPLICATIONS: Give 1 hr before meals and at bedtime; do not crush or chew tablets; take antacids 30 min before or 1 hr after sucralfate; increase fluids and dietary bulk | |||