Overview
This lecture covers key anti-ulcer medications, their mechanisms, uses, side effects, and important nursing considerations for gastrointestinal pharmacology.
Histamine-2 Receptor Antagonists (H2RAs)
- Includes ranitidine and famotidine.
- Used to treat GERD, duodenal/gastric ulcers, and Zollinger-Ellison syndrome.
- Work by blocking H2 receptors in the stomach to reduce acid secretion.
- Side effects: headache, GI upset.
Proton Pump Inhibitors (PPIs)
- Includes omeprazole and pantoprazole.
- Treat GERD, ulcers, and Zollinger-Ellison syndrome.
- Inhibit the enzyme needed for gastric acid secretion.
- Side effects: GI upset, risk of C. diff, bone fractures with long-term use.
- Monitor for diarrhea, cramping, and bloody stools.
Sucralfate
- Mucosal protectant for duodenal ulcers.
- Forms a protective paste over ulcers after reacting with stomach acid.
- Main side effect: constipation.
- Administer 1 hour before meals and at bedtime.
- Increase patient fiber and fluid intake to prevent constipation.
Antacids (e.g., Aluminum Hydroxide)
- Used for peptic ulcer disease and GERD.
- Neutralize stomach acid.
- Key side effect: constipation.
- Administer after meals and at bedtime.
- Do not give with other meds; separate by 1-2 hours.
Misoprostol
- Prostaglandin used to prevent gastric ulcers in patients taking NSAIDs and to induce labor by ripening the cervix.
- Decreases stomach acid, increases mucus and bicarbonate, causes uterine contractions.
- Side effects: dysmenorrhea, GI upset.
- Black box warning: can cause miscarriage, premature birth, and birth defects.
- Pregnancy test required before use in women of childbearing age.
Key Terms & Definitions
- GERD — Gastroesophageal reflux disease, a condition of stomach acid flowing back into the esophagus.
- Zollinger-Ellison syndrome — Rare disorder causing excessive gastric acid secretion.
- Mucosal protectant — Medication that shields ulcerated tissue from acid.
- Prostaglandin — Compound with hormone-like effects, such as reducing gastric acid or inducing labor.
Action Items / Next Steps
- Review anti-ulcer medication flashcards.
- Memorize administration timing for sucralfate and antacids.
- Remember to conduct a pregnancy test before starting misoprostol in applicable patients.