ACTIVITY 1:

TYPES OF ANTIULCER DRUGS

SYSTEMIC
NURSING
DRUG DESCRIPTION
RESPONSIBILITY

Sodium Drug Action: Neutralizes > Avoid administering

Bicarbonate gastric acidity antacids with other oral
(ALKA- Dosage: PO 2 tab dissolved drugs as antacids can delay
SELTZER) in water q4h their absorption
Contraindications:
Pregnancy and lactation; use > Monitor electrolytes and
with caution in clients with urinary pH, calcium and
renal impairment phosphate levels
Side effects: sodium excess
> Direct client not to take
Calcium Drug Action: Neutralizes antacids after meals as
Carbonate Hydrochloric acid they slow gastric emptying
(TUMS) Dosage: PO 2 tab q2h time
Contraindications:
Pregnancy and lactation; > Assist client in checking
renal dysfunction anatcid labels for sodium
Side effects: acid rebound, content if on a sodium-
constipation restricted diet

> Direct client to avoid

food and beverages that
can cause gastric irritation

NON-SYSTEMIC
NURSING
DRUG DESCRIPTION
RESPONSIBILITY

Magnesium Drug Action: Neutralizes > Avoid administering

Hydroxide gastric acidity antacids with other oral
Dosage: 2-4 tab PRN drugs as antacids can
Contraindications: delay their absorption
Side effects:
 > Monitor electrolytes and
Magnesium Drug Action: Neutralizes urinary pH, calcium and
Trisilicate gastric acidity phosphate levels
(GAVISCON) Dosage: PO 1-2 tab PRN
Contraindications: > Direct client not to take
Side effects: antacids after meals as
they slow gastric emptying
time

Aluminum Drug Action: Neutralizes > Warn client to avoid

Hydroxide gastric acidity taking antacids with milk
(AMPHOJEL, Dosage: 600 mg 1 h after or food high in Vitamin D
ALU-TAB) meals
Contraindications: > Direct client to avoid
Hypersensitivity to food and beverages that
aluminum products, can cause gastric irritation
hypophosphatemia
Side effects: Constipation > Periodically monitor
serum electrolytes to
> long-term use can result evaluate drug effects
to GI obstruction
> also used to treat
hyperphosphatemia in
clients with renal disoders
> increases the pH of
gastric secretions
> Primarily bound to
phosphate and excreted in
the feces

Simethicone Drug Action: Decreases

(MAALOX) flatus
Dosage: 2-4 tabs PRN
Contraindications:
Pregnancy and Lactation
Side effects: Nausea,
headache

H2 ANTAGONISTS
NURSING
DRUG DESCRIPTION
RESPONSIBILITY
Famotidine Drug Action: Inhibition of > Administer drug
(PEPCID) gastric acid secretion by before meals to decrease
inhibiting Histamine 2 receptors food-induced acid
in parietal cells secretion or at bedtime.
Dosage: 20 mg q12h or 40 mg at
bed time > Advise client to avoid
Contraindications: smoking as it can reduce
Side effects: Headache, the effectiveness of the
constipation drug

> 5-8 times more potent than > Direct client to

Ranitidine separate Ranitidine and
> indicated for short-term use antacid dosage by atleast
for duodenal ulcer 1 hour to avoid decrease
Ranitidine Drug Action: Inhibition of in effectiveness
(ZANTAC) gastric acid secretion by
inhibiting Histamine 2 receptors > Encourage food rich in
in parietal cells Vitamin B12 to avoid
Dosage: 150 mg q12h deficiency induced by
Contraindications: Severe renal drug therapy
or liver disease; pregnancy and
lactation > Warn client not to
Drug Interactions: Decrease drive or operate
absorption with anatcids machines until stabilized
Side effects: Headache, on the drug
constipation, diarrhea
> Arrange for decreased
> large doses is effective for dosage in cases of hepatic
controlling Zollinger-Ellison or renal dysfunction to
syndrome prevent serious toxicity
Cimetidine Drug Action: Inhibition of
(TAGAMET) gastric acid secretion by
inhibiting Histamine 2 receptors
in parietal cells
Dosage: 300 mg q.i.d
Drug interactions: enhances
effects of oral anticoagulants,
theophylline, caffeine, phenytoin
and calcium channel blockers
- can cause an increase in BUN,
serum creatinine and serum
alkaline phosphate
Side effects: Headache,
constipation, dizziness

> must be given an hour before

or after an antacid as part of
antiulcer drug regimen to
avoid decrease in effectiveness
 PROTON PUMP INHIBITORS
NURSING
DRUG DESCRIPTION
RESPONSIBILITY

Omeprazole Drug Action: suppresses > Administer drug before

(PRILOSEC) gastric acid secretion by meals; ensure that drug is
inhibiting the ATPase enzyme swallowed whole to ensure
system located in the gastric therapeutic effectiveness
parietal cell
Dosage: PO 20 mg/d for 4-8 > Provide appropriate
wk safety and comfort
Drug Interactions: enhances measures if CNS effects
the action of oral occur to prevent patient
anticoagulants, injury
benzodiazepines and
phenytoins > Offer support and
Side effects: headache, encouragement to help
dizziness, diarrhea, rash, client cope with the disease
constipation and the drug regimen

> can be combined with

antibiotics to treat H. pylori
Pantoprazole Drug Action: suppresses
(PROTONIX) gastric acid secretion by
inhibiting the ATPase enzyme
system located in the gastric
parietal cell
Dosage: PO/IV 40 mg/d
Side effects: headache,
dizziness, diarrhea, rash,
constipation

> prescribed to treat short-

term erosive GERD
> can be combined with
antibiotics to treat H. pylori
> taken before meals
Lansoprazole Drug Action: suppresses
(PREVACID) gastric acid secretion by
inhibiting the ATPase enzyme
system located in the gastric
parietal cell
Dosage: 30 mg b.i.d
Contraindications:
Hypersensitivity, pregnancy,
Lactation
Drug Interactions: decreases
theophylline levels
Side effects: headache,
dizziness, diarrhea, rash,
constipation

> can be combined with

antibiotics to treat H. pylori
> taken before meals

MUCOSAL PROTECTIVE DRUGS

DRUG DESCRIPTION NURSING RESPONSIBILITY

Bismuth Drug Action: combines with > Administer drug on empty

subsalicylate protein to form a viscous stomach
(PEPTO- substance that covers the ulcer
BISMOL) and protects it from acid or pepsin > Administer antacid 30 minutes
Dosage: PO 30 mL q1/2-1h PRN before or after sucralfate as it
Contraindications: binds with certain drugs reducing
Hypersensitivity to Bismuth, its effect
aspirin and salicylates
Side effects: Constipation, > Encourage increase intake of
abdominal pain, clay-colored/ fluids and fiber in the diet to relive
gray-black stool constipation

> Educate client on the need to

avoid liquids and food that can
cause gastric irritation
Sucralfate Drug Action:combines with
(CARAFATE) protein to form a viscous > Provide frequent mouth care;
substance that covers the ulcer and small, frequent meals if GI
and protects it from acid or pepsin effects are uncomfortable
Dosage: 1 g b.i.d
Contraindications:
Hypersensitivity to the drug; renal
failure
Side effects: Dizziness, nausea,
constipation, pruritus, dry mouth
 > used at a reduced dose for
maintenance of duodenal ulcers
after healing

PROSTAGLANDIN ANALOGUES
DRUG DESCRIPTION NURSING RESPONSIBILITY

Misoprostol Drug Action: suppress > Administer to clients at high risk

(CYTOTEC) gastric acid secretion and for NSAID-induced ulcers; with
increase cytoprotective meals and at bedtime
mucus in the GI tract
Dosage: PO 100-200 > Arrange for serum pregnancy
mcg q.i.d test within 2 weeks before
Contraindications: beginning treatment to ensure the
Pregnancy client is not pregnant and prevent
Side effects: Nausea, abortifacient effects associated
diarrhea, abdominal with the drug
pain, dyspepsia,
miscarriages > Provide thorough discussion on
associated risks of pregnancy;
Rebamipide Drug Action: suppress advise the use of barrier
(MUCOSTA) gastric acid secretion and contraceptives to ensure
increase cytoprotective prevention of pregnancy
mucus in the GI tract
Dosage: 100 mg t.i.d
Contraindications:
Hypersensitivity to
synthetic formulations,
dye and chemicals;
pregnancy and lactation
Side effects: Bloating,
constipation, diarrhea

REFERENCES:

Karch, A. M. (2008). Focus on Nursing Pharmacology (4th ed.). Philadelphia:

Lippincott Williams and Wilkins

Kee, J., Hayes, E., McCuistion, L. (2009). Pharmacology: A Nursing Approach

(6th ed.).Singapore: Elsevier Inc.