aluminium hydroxide gel (amphogel, alternaGel)
aluminium carbonate gel (basaljel)
bismuth subsalicylate (pepto-bismol)
calcium carbonate (tums) magnesium hydroxide (milk of magnesia, MOM)
description react with gastric acid to produce neutral salts or salts of low acidity
inactivate pepsin and enhance mucosal protection but do not coat the ulcer crater to protect it from teh acid and pepsin.
used for peptic ulcer disease and gastroesophageal reflux disease.
should be taken on a regular schedule
are usually administered severn times a day, 1 and 3 hourws after each meal and at bedtime
to provide maximum benefit, treatement should elevate the gastric pH above 5
antacid tablets should be chewed thoroughly and followed with a glass of water or milk.
liquid preparations should be taken before dispensing.
interactions with other medications can be minimized by allowing one hour between antacid administraiton and administration of other medications.
can interfere with the action of sucralfate (carafate) and to minimize this interaction, the medications should be administered 1 hour apart from each other.
creates a protective barrier against acid and pepsin.
administered orally; should be taken on an empty stomach
administer atleast 60 minutes apart from an antacid
may cause constipation
may impede absorption of warfarin sodium (coumadin), phenytoin (dilantin), theophylline, digoxin (lanoxin) and some antibiotics and should be administered atleast 2 hours apart from these medications.
used to prevent gastric ulcers caused by long term therapy with nonsteroidal antiinflammatory drugs (NSAIDS)
suppresses secretion of gastric acid
promotes secretion of bicarbonate and cytoprotective mucous.
maintains submucosal blood flow by promoting vasodilation
administered with meals.
causes diarrhea and abdominal pain
contraindicated for use in pregnancy.
also referred to as milk of magnesia
most prominent side effect is diarrhea
usually administered in combination with aluminium hydroxide; an antacid that assists in preventing diarrhea.
contraindicated in clients with intestinal obstruction, appendicitis, or clients with undiagnosed abdominal pain.
in clients with renal impariment, magnesium can accumulate to high levels, causing signs of toxicity.
aluminium hydroxide gel (amphogel, alternagel)
contains significant amounts of sodium
used with caution in clients with hypertension and heart failure
most common side effect is constipation
can reduce teh effect of tetracyclines, warfarin sodium (coumadin), and digoxin (lanoxin) can reduce phosphate absorption and thereby cause hypophosphatemia.
calcium carbonate (tums) rapid acting
common side effect is constipation
liberates carbon dioxide, increases intraabdominal pressure and flatulence.
used in caution with clients with hypertension and heart failure
can cause systemic alkalosis in clients with renal impairment
in useful for treating acidosis and elevating urinary pH to promote excretion of acidic medications after overdose.
suppress secretions of gastric acid
alleviate symptoms of heartburn and assist in preventing complications of peptic culcer disease
prevent stress ulcers and reduce the recurrence of all ulcers
promotes healing in GERD
contraindicated in hypersensitivity
used with caution in clients with impaired renal or hepatic function.
can be administered orally (IV); intramuscularly (IM), or intravenously (IV)
food reduces the rate of absorption if taken with meals, absorption will be slowed.
antacids can decrease the absorption of cimetidine
cimetidine and antacids should be administered atleast one hour apart from each other
passes the blood brain barrier, and central nervous system side effects can occur.
may cause mental confusion, agitation, psychosis, depression, anxiety and disorientation.
dosage should be reduced in clients with renal impairment.
IV administration can cause hypotension and dysrhythmias
if administered with warfarin sodium (coumadin), phenytoin (dilantin), theophylline or lidocaine (xylocaine), the dosages of these medications should be reduced.
can be administered orally, IM, IV
side effects are uncommon
unlike cimetidine, ranitidine (zantac) does not penetrate the blood-brain barrier.
zantac is not affected by food.
famotidine (pepcid) and nizatidine (axid)
similar to zantac and tagamet
do not need to be administered with food.
ranitidine bismuth citrate (tritec)
used to treat active duodenal ulcers associated with helicobacter pylori administered with the antibiotic clarithromycin (biaxin)
suppress the immune system and block normal hormones in hormone sensitive tumors
change teh hormonal balance and slow the growth rate of certain tumors.
anorexia, nausea and vomiting
impaired pancreatic function with asparaginase (elspar) gynecomastia
hemorrhagic cystitis, hypouricemia, and hypercholesterolemia with mitotane (lysodren)
sex characteristic alterations
tamoxifen citrate (nolvadex) may cause edema, and elevated cholesterol and triglyceride levels and decreases the effect of estrogen.
diethylstilbestrol (stilphostrol) may cause impotence and gynecomastia in mena and may alter effects of insulin, oral anticoagulants, and oral hypoglycemic agents.
monitor vital signs
ask the client about the medications currently taking
monitor serum calcium levels with androgens
monitor for signs of alterations in sexual characteristics
montir pancreatic functionwith asparaginase
encourage an oral intake of 2 to 3 liters of fluids per day
monitor uric acid and cholesterol levels
monitor for signs of hemorrhagic cystitis.
stimulate the immune system to recognize cancer cells and take action to eliminate or destroy them.
interleukins: help different immune system cells to recognize and destroy abnormal body cells.
interferons: slow down tumor cells division; stimulate proliferation and activiation of natural killer cells; and help cancer cells resume a more normal appearance and revert to their previous characteristics.
colony stimulating factors: induce more rapid bone marrow recovery after suppression by chemotherapy
prevent mitosis, causing cell death
mitotic inhibitor that prevents cell division
cell cycle phase specific and act on the M phase
neurotoxicity with vincristine sulfate (oncovin) manifested as numbness and tingling in the fingers and toes.
anorexia, nausea, and vomiting
phlebitis at IV site
monitor vital signs
monitor WBC, CBC, uric acid, and platelet counts
monitor for hoarseness
check the eye for ptosis
monitor motor stability and initate safety precautions as necessary
monitor for neurotoxicity with vincristine sulfate (oncovin) manifested as numbness and tingling in the fingers and toes.