Chapter 24 Agents Used to Treat Hyperacidity and Gastroesophageal Reflux Disease
Chapter 24 Agents Used to Treat Hyperacidity and Gastroesophageal Reflux Disease.
Jan 11, 2016
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Chapter 24Agents Used to Treat Hyperacidity and Gastroesophageal Reflux Disease
Copyright 2007 Thomson Delmar Learning, a division of Thomson Learning Inc. All rights reserved.
24 - 2
Secretory Functions of the Stomach Lining
Parietal cells secrete hydrochloric (HCl) acid
Chief cells secrete pepsinogen Mucoid cells secrete mucus
Copyright 2007 Thomson Delmar Learning, a division of Thomson Learning Inc. All rights reserved.
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Stomach Hyperchlorhydria
Produced from: Eating high-fat meals Increased alcohol intake Emotional turmoil
Copyright 2007 Thomson Delmar Learning, a division of Thomson Learning Inc. All rights reserved.
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Goal of Antacid Therapy
Neutralize the acid Inhibit pepsin activity Increase resistance of the stomach lining Increase tone of the lower esophageal
sphincter
Copyright 2007 Thomson Delmar Learning, a division of Thomson Learning Inc. All rights reserved.
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Antacids
Three Forms1. Aluminum2. Magnesium3. Calcium Mechanism of action
Neutralization of gastric acidity Low doses promote gastric mucosal
defensive mechanisms
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Systemic Antacids
Useful in short-term therapy Rapid onset Prolonged use causes an overload on the
kidneys Example: sodium bicarbonate
Copyright 2007 Thomson Delmar Learning, a division of Thomson Learning Inc. All rights reserved.
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Nonsystemic Antacids
Remain in gastrointestinal tract; useful in long-term therapy
Most of the dose remains in the gastrointestinal tract
Will not alter acid-base system Examples: calcium carbohydrate (Tums,
Rolaids), aluminum carbonate (Basaljel), magaldrate (Riopan), etc.
Copyright 2007 Thomson Delmar Learning, a division of Thomson Learning Inc. All rights reserved.
24 - 8
Side Effects and Adverse Effects
Magnesium: diarrhea Aluminum: constipation Calcium: constipation
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Antacid Interactions
Binding of other drugs to the antacid causes reduced availability of the other drugs to the client.
Chemical inactivation Increases stomach and urine pH
(alkaline), which decreases the absorption and excretion of certain drugs
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24 - 10
Nursing Interventions
Monitor for side effects Nausea, vomiting, abdominal pain, diarrhea With calcium-containing products:
constipation, acid rebound Monitor for therapeutic response
Notify heath care provider if symptoms are not relieved.
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24 - 11
Histamine (H2) Receptor Antagonists
Examples Cimetadine (Tagamet) Famotidine (Pepcid) Nizatidine (Axid) Ranitidine (Zantac)
Copyright 2007 Thomson Delmar Learning, a division of Thomson Learning Inc. All rights reserved.
24 - 12
Proton Pump Inhibitors
Omeprazole (Prilosec) Blocks the final step of acid production in the
stomach Indicated for clients with:
Gastroesophageal reflux disease (GERD) Gastric hypersecretory condition
Interactions Causes warfarin (an anticoagulant) action to
be increased
Copyright 2007 Thomson Delmar Learning, a division of Thomson Learning Inc. All rights reserved.
24 - 13
Helicobacter Pylori
An organism associated with the development of peptic ulcer disease
Treatment Metronidazole (Flagyl), an antimicrobial
agent, along with bismuth subsalicylate (Pepto-Bismol) and tetracycline (antimicrobial) for 4 weeks to eradicate Helicobacter pylori
Copyright 2007 Thomson Delmar Learning, a division of Thomson Learning Inc. All rights reserved.
24 - 14
Metoclopramide (Reglan)
A drug that stimulates the motility of the upper GI tract without stimulating the production of gastric, biliary, or pancreatic solutions
Action Increases peristalsis in the duodenum and
jejunum Decreases gastroesophageal reflux
(continues)
Copyright 2007 Thomson Delmar Learning, a division of Thomson Learning Inc. All rights reserved.
24 - 15
Metoclopramide (Reglan)
Adverse effects Produces extrapyramidal (Parkinson-like
symptoms) effects Central nervous system depression Gastrointestinal upset
(continued)
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