ANTACIDS

A N T A C I D S
A R E T A K E N B Y M O U T H
E S O P H A G E A L
T R E A T M E N T W I T H A N T A C I D S
A L O N E
T H E T R E A T M E N T
O F U L C E R S M A Y
R E
A N

T O R E L I E V E H E A R T B U R N , T H E M A J O R
S Y M P T O M O F
R E F L U X D I S E A S E O R A C I D I N D I G E S T I O N . .
I S S Y M P T O M A T I C
A N D
O N L Y J U S T I F I E D F O R M I N O R
Q U I R E H 2 - R E C E P T O R A N T A G O N I S T S ,
P R O T O N P U M P
D
E R A D I C A T I O N O F H . P Y L O R I

G A S T R O S Y M P T O M S .
I N H I B I T O R S

ANTACIDS
magnesium and aluminum hydroxide combinations (Maalox,
Mylanta, Riopan, Gaviscon)
Gelusil,
Amphogel
Rolaids CaCO3 and Mg(OH)2
Tums CaCO3
Nursing Implication
May prevent other meds from being absorbed
May cause rebound acidity if overused
Check for compromised renal function
Watch for side effects

H. PYLORI AGENTS FOR GASTRIC

ULCERS
Will use 2 of the following:

amoxicillin (Amoxil, Trimox,Wymox)

clarithromycin (Biaxin)
metronidazole (Flagyl) &
tetracyclin (Achromycin)
Helidac, Prevpac, Tritec.

PPI END IN PRAZOLE

Main action is a pronounced and long-lasting
reduction of gastric acid production. They are the
most potent inhibitors of acid secretion available
today.
The group followed and has largely superseded H2receptor antagonists. These drugs are among the
most widely-selling drugs in the world and are
generally considered effective.
High dose or long-term use of PPIs carry a possible
increased risk of bone fractures.

PPI USED FOR

Dyspepsia
Peptic ulcer disease (PUD)
Gastroesophageal reflux disease (GERD)
Laryngopharyngeal reflux
Barretts esophagus (chronic damage-thickened)
Prevention of stress gastritis
Gastrinomas & other conditions that cause
hypersecretion of acid
Zollinger-Ellison syndrome (chronic hyper acid)
The FDA advises that no more than three 14-day
treatment courses should be used in one year.

PPI SIDE EFFECTS

Headaches,dizziness, vertigo,
Palpitations, flushing
Dry mouth, taste changes, constipation, anorexia
Dry skin, acne
Liver, kidney problems

PPI END IN PRAZOLE

omeprazole (brand names: Losec, Prilosec, Zegerid,
ocid, Lomac, Omepral, Omez)
lansoprazole (brand names: Prevacid, Zoton,
Monolitum, Inhibitol, Levant, Lupizole)
dexlansoprazole (brand name: Kapidex, Dexilant)
esomeprazole (brand names: Nexium, Esotrex)
pantoprazole (brand names: Protonix, Somac,
Pantoloc, Pantozol, Zurcal, Zentro, Pan, Controloc)
rabeprazole (brand names: Zechin, Rabecid, NzoleD, AcipHex, Pariet, Rabeloc. Dorafem: combination
with domperidone

H2 RECEPTOR ANTAGONISTS (END IN

TIDINE)

are a class of drugs used to block the action of histamine

on parietal cells in the stomach, decreasing the
production of acid by these cells.
H2 antagonists are used in the treatment of, dyspepsia
although they have been surpassed in popularity by the
more effective proton pump inhibitors.
In the United States, all four FDS-approved members of
the group

cimetidine (Tagamet),
ranitidine (Zantac),
famotidine (Pepcid) and
nizatidine (Axid)

are available OTC (over the counter) in relatively low

doses

ANTIEMETICS
An antiemetic is a drug that is effective against
nausea and vomiting
Antiemetics are typically used to treat:

motion sickness
side effects of general anesthesia &
opioid analgesics
chemotherapy directed against
cancer.

ANTIEMETICS
used to prevent or treat nausea & vomiting. Multiple
causes, including: systemic illness, GI immobility or
infection, pain, motion sickness, & post anesthesia.

dimenhydrinate (Dramamine,
Dimetabs)
meclizine hcl (Antivert, Bonine)
metoclorpramide (Reglan, Reclomide)
ondansetron hcl (Zofran)
prochlorperazine (Compazine)
trimethobenzamide hcl (Tigan, Ticon)

NAUSEA & VOMITING

NURSING IMPLICATIONS
attempt to decrease stimulant to n/v.
medicate for pain as needed,
treat any infection with AB, fluids, rest.
small frequent meals of easily digested foods
cool, clean smelling environment
watch other irritations: noise, commotion though distraction
may also help (music, cold compress)
give medications with appropriate techniques.
be aggressive.sort of.

5-HT3 RECEPTOR ANTAGONISTS (MOST

END IN SETRON)

these block serotonin receptors in the CNS & GI

tract.
used to treat post-operative and cytotoxic drug
nausea & vomiting. Side effects are constipation,
diarrhea, dry mouth & fatigue. [2]
dolasetron (Anzemet)
granisetron (Kytril, Sancuso)
ondansetron (Zofran)
tropisetron (Navoban)
palonosetron (Aloxi)
mirtazapine (Remeron)

DOPAMINE ANTAGONISTS
act in the brain and are used to treat N & V associated
with neoplastic disease, radiation sickness, opioids,
cytotoxic drugs and general anesthetics.
Side effects include muscles spams & restlessness.
domperidone
olanzapine
droperidol, holoperidol, chlorpromazine, promethazine
(Phenergan). Some of these drugs are limited in their
usefulness by their extra pyramidal & sedative sideeffects.
prochlorperazine (Compazine, Stemzine, Buccastem,
Stemetil, Phenotil)

ANTIHISTAMINES

(H1 HISTAMINE RECEPTOR

ANTAGONISTS)
blocks Acetylcholine in brain.
effective in many conditions, including motion
sickness, morning sickness in pregnancy, and to
combat opioid nausea.
Some antihistamines are also used to prevent
dizziness, or to help people go to sleep and control
anxiety before or after surgery.
Used in many sinus, allergy & cold medicines.

ANTIHISTAMINES

cyclizine (Marazine)
diphenhydramine (Benadryl)
dimenhydrinate (Gravol, Dramamine)
meclizine (Bonine, Antivert)
promethazine (Pentazine, Phenergan)
hydroxyzine (Atarax, Vistaril)
cetirizine (Zyrtec)
fexofenodine (Allegra)
Loratadine (Claritin)

PROSTAGLANDINS
misoprostol (Cytotec) is used to prevent ulcers in
people who take certain arthritis or pain medicines,
including aspirin, that can cause ulcers. It protects
the stomach lining and decreases stomach acid
secretion.
especially indicated for the on continuous doses of
NSAIDs.
can also be used in the management of openangle glaucoma.

PROSTAGLANDINS
NURSING IMPLICATIONS:
may require administration before/after meals, with or
without food.
Check BMs for bleeding (black tarry stools + odor)
check side effects: gastric distress, diarrhea, rashes or
hives, nausea, vomiting, effect on other medications, food
to avoid when taking.
Contraindicated during pregnancy, can induce labor

PHENOTHIAZINES
Prevent histamine responses & used for motion sickness, pre &
post-op sedation with analgesics. Used in psychiatric
disorders psychosis, schizophrenia

chlorpromazine (Thorazine)
prochlorperazine (Compazine)
promethazine (Phenergan)
thiethylperazine (Torecan)

CNS depressant with SE of sedation, drowsiness,

disorientation, blurred vision, urine retention,
photosensitivity, blood disorders: leukopenia,
agranulocytosis, thrombocytopenia
Lots of contra indications with other meds

MEDS THAT MAY BE USED ON GI TRACT

Digestants assist with process of digesting

Pancreatic drugs give with meals or food

Observe for decreased caloric intake & weight loss
Weigh clients at regular intervals
Pancreatin, Pancrelipase
May be multiple capsules just before eating.

Misc: Reglan (GI stimulant)