GI Drugs - Antacids

Which antacid would be the best option for a patient with chronic anemia who takes an iron pill daily and is being treated for PUD? Sodium bicarbonate Magnesium hydroxide Calcium carbonate Aluminum hydroxide

Magnesium hydroxide • Iron supplements cause constipation • Calcium/aluminum cause constipation • Magnesium antacids cause diarrhea • Sodium bicarb does not treat PUD

What do antacids do?

Neutralize hydrochloric acid in the stomach • Lowers pepsin activity • Increases prostaglandin production (↑ mucosa)

Which antacid has the potential to cause kidney stones? Sodium bicarbonate Aluminum hydroxide Magnesium hydroxide Calcium carbonate

Calcium carbonate Calcium carbonate may cause calcium kidney stones.

A patient with kidney stones is taking medication for peptic ulcer disease. What information would be beneficial for this patient? Aluminum hydroxide may cause kidney stones. Calcium carbonate may cause kidney stones. Taking antacids do not increase the risk of getting kidney stones. Magnesium hydroxide may cause kidney stones.

Calcium carbonate may cause kidney stones.

The nurse is caring for a patient on a heart failure diet (low sodium). Which advice would the nurse give this patient regarding over-the-counter antacids? Antacids pose no potential threat for her heart condition. Antacids are not indicated for those with heart failure. Check the labels of over the counter antacids for sodium content. Assure her that all over the counter antacids have a low sodium content.

Check the labels of over the counter antacids for sodium content.

What antacid would you use with a patient who has constipation?

Combination aluminum-magnesium antacid • Aluminum and calcium antacids cause constipation • Magnesium antacids cause diarrhea • Combination-based antacids have reduced side effects

Antacids promote the integrity of the abdominal wall by neutralizing which acid? Lipase Gastric Amylase Lactase

Gastric Antacids interact with gastric acid to produce neutral salts that act to decrease the destruction of the abdominal wall.

How may diet contribute to gastric irritation in a patient with PUD? A bland diet may contribute to PUD. Diet does not contribute to PUD. A low-fat diet is not recommended. High fat diet, spicy meals, caffeine-containing foods, and alcohol should be avoided.

High fat diet, spicy meals, caffeine-containing foods, and alcohol should be avoided.

What antacid would you avoid with a patient with hypertension?

Sodium bicarbonate • Can increase water reabsorption, which can increase BP further

Which antacid for PUD is contraindicated for patients with kidney disease? Sodium bicarbonate Magnesium hydroxide Aluminum hydroxide Potassium chloride

Sodium bicarbonate • Too many side effects! • Can cause systemic alkalosis in patients with renal impairment.

Which antacid is unsuitable for treating peptic ulcers? Magnesium hydroxide Aluminum hydroxide Sodium bicarbonate Calcium carbonate

Sodium bicarbonate • Too short-lasting to be effective • Hypernatremia risk • Metabolic alkalosis risk • Acid bound (↑ acid secretion) risk

When a patient is taking self-prescribed antacids, at what point should the patient seek medical advice? One month Six weeks Two weeks Five days

Two weeks A patient should seek medical advice before taking self-prescribed antacids for longer than 2 weeks.

When should antacids be taken in relation to other medications? 1-2 hours before medication With all medications 1-2 hours after medications 30 minutes after medications

1-2 hours after medications Antacids may delay the absorption of oral medications and should be taken 1-2 hours after medications.

What are 2 non-systemic antacids?

Alkaline salts: • Magnesium hydroxide • Aluminum hydroxide (do not produce body-wide effects)

Which medication teaching would be important for a patient taking phenytoin for seizures and antacids for PUD? Instruct him to take his phenytoin as prescribed, as there is no drug interaction between phenytoin and antacids. Antacids increase the absorption of phenytoin and so his drug levels should have been high. Antacids impede the absorption of phenytoin when taken together and should not be taken together. Antacids should be taken 30 minutes after taking phenytoin.

Antacids impede the absorption of phenytoin when taken together and should not be taken together. • Antacids should be taken 1-2 hours after taking phenytoin to prevent its absorption.

A patient has been taking calcium carbonate every 2 hours for symptoms with minimal relief and states that he has been taking this medication for months. Which advice should the nurse offer? It is okay to take over-the-counter antacids frequently if symptoms are relieved. Over-the-counter antacids are safe to take long-term. If antacids are needed for longer than 2 weeks, the patient should seek medical care. When calcium carbonate was not providing relief, the patient should have switched to a different over-the-counter antacid.

If antacids are needed for longer than 2 weeks, the patient should seek medical care.

Why is drinking 2-4 ounces of water recommended after taking a liquid antacid? It facilitates systemic absorption Helps with nausea associated with antacids Helps with diarrhea associated with antacids Increases gastric emptying time

Increases gastric emptying time

The nurse is assessing a patient who has been taking ciprofloxacin to treat an infection. The nurse learns that the patient has recently been taking over-the-counter antacids for heartburn. Which medication teaching would be important for this patient? Instruct the patient that antacids should not be taken with ciprofloxacin. Tell the patient that only aluminum hydroxide is recommended to take with ciprofloxacin. Assure the patient that it is safe to take over-the-counter antacids with ciprofloxacin. Teach the patient that the safest over-the-counter antacid to use with ciprofloxacin is sodium bicarbonate.

Instruct the patient that antacids should not be taken with ciprofloxacin.

Antacids are primarily used to treat which condition? Gastroesophageal reflux disease Irritable bowel syndrome Peptic ulcer disease Pancreatitis

Peptic ulcer disease

What is the primary indication for antacid use?

Peptic ulcer disease (PUD)

A patient has osteoporosis and is taking supplemental calcium with vitamin D. The nurse notices the patient is also taking calcium carbonate for antacid relief. Which teaching would be beneficial for this patient? Teach her she is at risk of developing hypercalcemia. Teach her that the extra calcium is a safe benefit in treating her osteoporosis. Teach her she at risk of developing hypocalcemia. Assure her that her current list of medication poses no health risks.

Teach her she is at risk of developing hypercalcemia.

The nurse is reviewing home medications with the patient. The patient states she always takes her aluminum hydroxide antacid on a full stomach. Which teaching would be beneficial for this patient? Tell her she is taking this medication appropriately. Teach her she should also take her antacid with her medications. Teach her to take her antacids 1-3 hours after meals. Teach her to restrict her water intake if she is taking liquid antacids.

Teach her to take her antacids 1-3 hours after meals. Food decreases gastric emptying, and can cause an increase in GI activity and gastric secretions.

The nurse is admitting a patient who states an increase in belching and passing gas. The patient denies any diet changes but states that he has been taking Tums more frequently. What is the nurse's best response? Teach him that Tums do not cause belching or flatulence. Teach him he should increase his dose of Tums to decrease these symptoms. Teach him that Tums may be causing belching or flatulence. Advise him to switch to a magnesium sulfate antacid, which has no side effects.

Teach him that Tums may be causing belching or flatulence. Calcium carbonate (Tums) releases carbon dioxide in the stomach, which may cause belching or flatulence.

A patient with PUD states he stopped taking his antacid due to constipation. Which advice can the nurse offer? Tell him that he must take the medications that his physician prescribed to treat PUD. Tell him all antacids cause constipation. Tell him constipation is a lesser health problem than PUD. Tell him to ask his physician about magnesium hydroxide to take along with his prescribe antacid.

Tell him to ask his physician about magnesium hydroxide to take along with his prescribe antacid. A side effect of magnesium hydroxide is diarrhea and may be prescribe to take with other antacids that cause constipation to promote compliance.

The nurse is caring for a patient who had recent surgery for a bowel obstruction. The patient is awaiting return of bowel activity and states that he needs his antacid medication. How should the nurse respond? Obtain an order for the antacid. Tell the patient antacids are not recommended after GI surgery. Tell the patient he can only have a calcium carbonate antacid after his GI surgery. Tell the patient his antacids will resume when he is eating a regular diet and able to take them on a full stomach.

Tell the patient antacids are not recommended after GI surgery. • Antacids are avoided after GI surgery because they can cause constipation.

A patient presents with nausea, vomiting, and diarrhea, and is diagnosed with a small bowel obstruction. He states he has not taken any medications, except for Alternagel (aluminum hydroxide antacid). Which medication teaching would be beneficial for this patient? Tell the patient he was smart for attempting to treat his symptoms with an antacid. Tell the patient antacids should never be taken when there is a risk of a bowel obstruction. Assure the patient that antacids do not adversely affect the GI system. Tell the patient that magnesium hydroxide would have been a better antacid to take, as it does not cause constipation.

Tell the patient antacids should never be taken when there is a risk of a bowel obstruction. • Side effect of constipation may worsen the obstruction • No antacid is indicated when there is risk of a GI obstruction.

During an assessment, a patient tells the nurse that his gout medicine does not seem to be working anymore. What does the nurse notice upon interviewing the patient and reviewing his medications that may be contributing to increased gout-related pain? The patient states that his antacid is never taken with allopurinol. The patient takes his antacid 1-2 hours after taking his allopurinol. The patient is taking an antacid at the same time as his other medications, including his allopurinol. The patient stopped taking his antacid six months ago.

The patient is taking an antacid at the same time as his other medications, including his allopurinol. The presence of antacids interferes with the absorption of allopurinol and reduces the effectiveness of allopurinol.

What are 2 systemic antacids?

• Calcium carbonate • Sodium bicarbonate (produce body-wide effects)

What foods/meds are contraindicated with antacid use? What lifestyle advice would you discuss with Mrs. Woods? Mrs. Woods should increase her intake of milk or calcium products. Mrs. Woods should increase her walking each day. Mrs. Woods should limit her spicy food and alcohol intake. Mrs. Woods should switch to ibuprofen for pain.

• Milk/calcium productions (fat increases acid secretions) • Spicy foods • Alcohol • NSAIDs like ibuprofen, aspirin (increases gastritis risk)