Week 1 Sherpath: Antacid Therapy

Which phrases accurately describe the mechanisms of action exerted by antacids? Select all that apply. A. Raise gastric pH B. Lower pepsin activity C. Reduce acid secretion D. Neutralize stomach acidity E. Provide a protective barrier over an ulcer

A, B and D Raise gastric pH Antacids are effective in the treatment of heartburn and indigestion by raising gastric pH. Lower pepsin activity Antacids are effective in the treatment of heartburn and indigestion by lowering pepsin activity. Neutralize stomach acidity Antacids are effective in the treatment of heartburn and indigestion by neutralizing hydrochloric acid in the stomach.

Which statements regarding the absorption of calcium carbonate are accurate? Select all that apply. A. Absorption of calcium varies with age. B. During pregnancy, calcium absorption doubles. C. Calcium absorption occurs mostly in the jejunum. D. Calcium absorption is reduced in achlorhydria and uremia. E. The absorption of calcium depends on calcitriol and vitamin D. F. Food reduces the absorption of calcium carbonate by 10% to 30%.

A, B, D and E Absorption of calcium varies with age. This statement is accurate in that the mean absorption of calcium varies with age. During pregnancy, calcium absorption doubles. Due to fetal demands, calcium absorption doubles during pregnancy. Calcium absorption is reduced in achlorhydria and uremia. The absorption of calcium is reduced in achlorhydria and uremia. The absorption of calcium depends on calcitriol and vitamin D. When calcium is absorbed in the duodenum, it depends on calcitriol and vitamin D.

Which statement by the nursing student in regard to the pharmacokinetic parameters of calcium carbonate requires further intervention? A. "The solubility of calcium is decreased in an acidic environment." B. "Calcium carbonate distributes primarily into bone and teeth." C. "Calcium carbonate is 40% protein bound." D. "Excretion of calcium is mostly in the feces with some excretion in the urine."

A. "The solubility of calcium is decreased in an acidic environment." This statement is inaccurate. The solubility of calcium is increased, not decreased, in an acidic environment.

Which time frame describes when a patient will begin to experience relief from treatment with magnesium hydroxide? A. 0.5 to 6 hours B. 8 to 12 hours C. 20 to 24 hours D. 36 to 72 hours

A. 0.5 to 6 hours A patient receiving magnesium hydroxide can expect to experience relief with therapy between 0.5 and 6 hours.

Which patient parameters would a nurse ensure are assessed before a patient receives calcium carbonate? Select all that apply. A. Weight B. Calcium levels C. Renal function D. Blood pressure (BP) E. Phosphate levels

B, C and E Calcium levels Calcium levels should be evaluated in patients before administration of calcium carbonate, as the antacid is systemically absorbed. Renal function Renal function should be evaluated in patients before administration of calcium carbonate, as the antacid is systemically absorbed and may accumulate in renal impairment. Phosphate levels Phosphate levels should be evaluated in patients before administration of calcium carbonate, as the antacid is systemically absorbed.

Which patients would a nurse determine require cautious use or avoidance of aluminum hydroxide? Select all that apply. A. A 51-year-old patient with gout B. A 29-year-old patient who is pregnant C. A 71-year-old patient with dyslipidemia D. A 55-year-old patient with chronic kidney disease E. A 29-year-old patient with hypophosphatemia

B, C, D and E A 29-year-old patient who is pregnant Pregnancy is a precaution for treatment with aluminum hydroxide. A 71-year-old patient with dyslipidemia Older patients should cautiously use aluminum hydroxide. A 55-year-old patient with chronic kidney disease Renal impairment is a precaution for treatment with aluminum hydroxide. A 29-year-old patient with hypophosphatemia Hypophosphatemia is a contraindication to treatment with aluminum hydroxide.

Which time frame describes how long a patient can expect the effects of aluminum hydroxide to last? A. 15 to 30 minutes B. 1 to 3 hours C. 4 to 6 hours D. 10 to 12 hours

B. 1 to 3 hours Aluminum hydroxide's duration of action is 1 to 3 hours.

Which time frame can a nurse expect aluminum hydroxide to reach its peak concentration? A. 15 minutes B. 30 minutes C. 60 minutes D. 90 minutes

B. 30 minutes The time to reach the peak concentration for aluminum hydroxide is 30 minutes.

Which statement about the classification of antacids is accurate? A. Magnesium hydroxide is a systemic antacid that can cause diarrhea. B. Aluminum hydroxide is a non-systemic antacid that can cause constipation. C. Calcium carbonate is a non-systemic antacid and can lead to hypercalcemia. D. Sodium bicarbonate is systemically absorbed and may cause metabolic acidosis.

B. Aluminum hydroxide is a non-systemic antacid that can cause constipation.The non-systemic antacid aluminum hydroxide may cause constipation.

Which outcome would a nurse anticipate might occur when magnesium hydroxide is administered with phenytoin? A. Enhanced absorption and efficacy of phenytoin B. Decreased absorption and efficacy of phenytoin C. Enhanced absorption and efficacy of magnesium hydroxide D. Decreased absorption and efficacy of magnesium hydroxide

B. Decreased absorption and efficacy of phenytoin When phenytoin and magnesium hydroxide are coadministered, the efficacy of phenytoin is decreased because the GI absorption of the phenytoin is impeded.

Which effect would a nurse monitor for in a patient who is receiving glipizide, a sulfonylurea, and aluminum hydroxide? A. Diarrhea B. Hypoglycemia C. Hyperglycemia D. Aluminum toxicity

B. Hypoglycemia Hypoglycemia may occur when a sulfonylurea and aluminum hydroxide are taken together. The effect of the sulfonylurea may be chemically enhanced by the antacid due to the effects of pH.

A nurse is caring for a patient who takes calcium carbonate and was recently prescribed ciprofloxacin, a quinolone, for a urinary tract infection. Which teaching point would the nurse share with this patient about administration of these drugs? A. These two drugs may be safely taken together on an empty stomach. B. Take calcium carbonate 1 to 2 hours after ciprofloxacin. C. Take ciprofloxacin 1 to 2 hours after calcium carbonate. D. Take calcium carbonate with meals and ciprofloxacin together with food.

B. Take calcium carbonate 1 to 2 hours after ciprofloxacin. Calcium carbonate should be taken 1 to 2 hours after ciprofloxacin has been administered. Taking them together can decrease the absorption of ciprofloxacin by 50%, thereby reducing its efficacy.

A patient who takes an antacid frequently for persistent heartburn presents with confusion and extreme muscle weakness. The patient is also having difficulty speaking. Which antacid would a nurse suspect this patient may have been receiving in excess? A. Calcium carbonate B. Sodium bicarbonate C. Aluminum hydroxide D. Magnesium hydroxide

C. Aluminum hydroxide The patient is experiencing signs and symptoms of aluminum toxicity. This is characterized by speech problems, muscle weakness, confusion, bone pain, and seizures. Therefore the potential causative agent is aluminum hydroxide, particularly because this patient has been frequently and excessively using antacids.

Which patients would a nurse determine have precautions to treatment with calcium carbonate? Select all that apply. A. A patient with osteoporosis B. A patient with prostate cancer C. A patient with type 2 diabetes mellitus D. A patient with hypoparathyroid disease E. A patient with renal dysfunction on dialysis

D and E A patient with hypoparathyroid disease Hypoparathyroid disease is a precaution for treatment with calcium carbonate, and the nurse should monitor the patient closely if the patient receives therapy. A patient with renal dysfunction on dialysis Renal dysfunction is a precaution for treatment with calcium carbonate, and the nurse should monitor the patient closely if the patient receives therapy.