Karch's Focus on Pharmacology 8th Ed. | Chapter 57

A female client has GERD and is taking ranitidine (Zantac). She continues to have gastric discomfort and asks whether she can take an antacid. Which is an appropriate response by the nurse?

"Yes, but be sure to wait at least 2 hours to take the antacid after you take the ranitidine." Rationale: If both ranitidine and antacids are prescribed, give them at least 2 hours apart to prevent decreased absorption of ranitidine. The nurse should advise the patient to wait at least 2 hours between doses and to take the antacid after the ranitidine. The other three statements are not true.

The nursing instructor is discussing the use of histamine2 receptor antagonists in the treatment of peptic ulcer disease. According to the instructor, which is a typical dosing schedule of famotidine during the first few weeks of treatment for gastric ulcer in patients with normal renal function?

20 mg bid Rationale: During the first few weeks of treatment for gastric ulcer, 40 mg of famotidine is administered at bedtime each day or 20 mg is administered twice daily. Thereafter, the typical maintenance dose is 20 mg at bedtime each day. Dosage is typically reduced in patients with impaired renal function.

Which would a nurse anticipate as having antiandrogenic effects?

Cimetidine

A client arrives at the walk-in clinic reporting vomiting and a burning sensation in the mid-epigastric region. The nurse suspects that the client has peptic ulcer disease. Which is a potential cause of peptic ulcer disease?

Infection with H. pylori

A nurse is reviewing information about proton pump inhibitors. The nurse recognizes that which of the following is available as an over-the-counter agent?

Omeprazole (Prilosec) Rationale: Omeprazole is available over the counter; lansoprazole, rabeprazole, and esomeprazole are prescription medications.

Why might a proton pump inhibit (PPI) be preferable to an a histamine2 receptor antagonists (H2RA) for the treatment of gastroesophageal reflux disease (GERD)? Select all that apply.

PPIs facilitate faster healing. PPIs suppress acid more effectively. PPIs act for a longer period of time.

A female client presents to the health care provider's office with increasing stomach acidity. She self-administers calcium antacids. She notes that she seems to be having more issues with stomach acid, so she has been taking the calcium antacids more frequently. The nurse suspects that this may have caused what to occur in this client?

Rebound acidity

The client has a magnesium-based antacid prescribed for administration before meals. The nurse knows to withhold the medication if the client exhibits what?

Renal dysfunction

Client teaching should include what instruction about antacids?

Take antacid 1 hour before other medications.

A nurse is providing education to a 23-year-old female client who has been prescribed misoprostol. What instruction should the nurse include in the teaching?

Use effective contraceptive measures.

Ranitidine and cimetidine are both H2RAs used in the treatment of peptic ulcer disease. Of the two, ranitidine is preferred in critically ill clients because it is less likely to:

interfere with the metabolism of other drugs.