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Pharmacology II
Antacid Therapy
| Question | Answer |
|---|---|
| Systemic Antacids | Sodium Bicarb: systemically absorbed, and excessive amounts can cause metabolic alkalosis. Because of the systemic absorption, sodium bicarbonate is rarely used for the treatment of peptic ulcers. Calcium Carbonate: can lead to hypercalcemia. |
| Non-Systemic Antacids | Aluminum Magnesium |
| antacids | agents that neutralize stomach acidity (hydrochloric acid), lower pepsin activity, and raise the gastric pH (do not protective barrier or coating over the ulcer) |
| 4 main Aluminum hydroxidetypes of antacids | aluminum compounds, magnesium compounds, calcium compounds, and sodium compounds |
| Aluminum hydroxide | can cause constipation, |
| magnesium hydroxide | can cause diarrhea |
| Sodium Bicarb | systemically absorbed, and excessive amounts can cause metabolic alkalosis. Because of the systemic absorption, sodium bicarbonate is rarely used for the treatment of peptic ulcers. |
| Calcium Carbonate | systemically absorbed, can lead to hypercalcemia. |
| Aluminum Hydroxide Absorption | Minimal absorption through intestine |
| Before the administration of an antacid, a nurse should: | Evaluate the patient’s pain, including type, duration, severity, and frequency. Assess for fluid and electrolyte imbalances, especially serum phosphate and calcium levels. Evaluate the patient’s renal and hepatic function. Obtain drug history; notify t |
| Contraindications and Precautions for Aluminum Hydroxide | Contraindications: Hypersensitivity to aluminum products and hypophosphatemia Precautions: Hepatic and renal disease, older adults, children, and pregnancy |
| Aluminum Hydroxide Excretion | In feces by binding to phosphate; small amount in urine |
| Magnesium Hydroxide Absorption | Bioavailability is about 15% |
| Magnesium Hydroxide and aluminum hydroxide metabolism and Distribution | distribution and metabolism of these antacids are Unknown |
| Contraindications and Precautions for Magnesium Hydroxide | Contraindications: GI obstruction Precautions: Myasthenia gravis, renal impairment, diarrhea, and older adults |
| Magnesium Hydroxide Excretion | In urine (up to 30% as absorbed magnesium ions); in feces (as unabsorbed drug) |
| Calcium Carbonate Absorption | Absorption mostly occurs in the duodenum and depends on calcitriol and vitamin D. Food increases absorption by 10%-30%. Mean absorption varies with age. Absorption doubles during pregnancy. Solubility increases in acidic environments. Reduced absorption o |
| Calcium Carbonate Distribution | Primarily distributes to bone and teeth |
| Calcium Carbonate Metabolism | Calcium carbonate is 40% protein bound |
| Calcium Carbonate Excretion | In mostly feces and with some in urine |
| Aluminum Hydroxide onset | Fairly rapid; within 15-30 minutes. However, this can vary if taken with food. |
| Aluminum Hydroxide peak | 0.5 hr |
| Aluminum Hydroxide Duration | 1-3 hr, unavail half life |
| Magnesium Hydroxide onset | 0.5-6 hr |
| Magnesium Hydroxide and calcium carbonate Peak and duration | peak and duration of these antacids are unknown |
| Which statements regarding the absorption of calcium carbonate are accurate? Select all that apply. Absorption of calcium varies with age. During pregnancy, calcium absorption doubles. Calcium absorption occurs mostly in the jejunum. Calcium absorpti | Absorption of calcium varies with age. During pregnancy, calcium absorption doubles. Calcium absorption is reduced in achlorhydria and uremia. The absorption of calcium depends on calcitriol and vitamin D. |
| Which time frame describes when a patient will begin to experience relief from treatment with magnesium hydroxide? 0.5 to 6 hours 8 to 12 hours 20 to 24 hours 36 to 72 hours | 0.5 to 6 hours A patient receiving magnesium hydroxide can expect to experience relief with therapy between 0.5 and 6 hours. |
| Contraindications and Precautions for Calcium Carbonate | Contraindications: None Precautions: Renal impairment, hypercalcemia, and hypoparathyroid disease |
| For patients receiving antacids, the nurse should perform the following: | Assess the patient’s GI status. Monitor the patient’s laboratory values, especially electrolytes like calcium and phosphate. Monitor lung sounds, especially in patients with heart failure, because some antacids are high in sodium, which can potentiate h |
| Which patient parameters would a nurse ensure are assessed before a patient receives calcium carbonate? Weight Calcium levels Renal function Blood pressure (BP) Phosphate levels | calcium levels renal functions phosphate levels |
| Which patients would a nurse determine require cautious use or avoidance of aluminum hydroxide? A 51-year-old patient with gout A 29-year-old patient who is pregnant A 71-year-old patient with dyslipidemia A 55-year-old patient with chronic kidn | A 29-year-old patient with hypophosphatemia A 55-year-old patient with chronic kidney disease A 29-year-old patient who is pregnant A 71-year-old patient with dyslipidemia |
| Which statement by the nursing student in regard to the pharmacokinetic parameters of calcium carbonate requires further intervention? “The solubility of calcium is decreased in an acidic environment.” “Calcium carbonate distributes primarily into b | “The solubility of calcium is decreased in an acidic environment.” |
| Which statement about the classification of antacids is accurate? Magnesium hydroxide is a systemic antacid that can cause diarrhea. Aluminum hydroxide is a non-systemic antacid that can cause constipation. Calcium carbonate is a non-systemic ant | Aluminum hydroxide is a non-systemic antacid that can cause constipation. |
| Which time frame can a nurse expect aluminum hydroxide to reach its peak concentration? 15 minutes 30 minutes 60 minutes 90 minutes | 30 minutes |
| Which phrases accurately describe the mechanisms of action exerted by antacids? Select all that apply. Raise gastric pH Lower pepsin activity Reduce acid secretion Neutralize stomach acidity Provide a protective barrier over an ulcer | Raise gastric pH Lower pepsin activity Neutralize stomach acidity |
| Which outcome would a nurse anticipate might occur when magnesium hydroxide is administered with phenytoin? Enhanced absorption and efficacy of phenytoin Decreased absorption and efficacy of phenytoin Enhanced absorption and efficacy of magnesium | Decreased absorption and efficacy of phenytoin |
| Which effect would a nurse monitor for in a patient who is receiving glipizide, a sulfonylurea, and aluminum hydroxide? Diarrhea Hypoglycemia Hyperglycemia Aluminum toxicity | Hypoglycemia |
| Which patients would a nurse determine have precautions to treatment with calcium carbonate? Select all that apply. A patient with osteoporosis A patient with prostate cancer A patient with type 2 diabetes mellitus A patient with hypoparathyr | A patient with hypoparathyroid disease Hypoparathyroid disease is a precaution for treatment with calcium carbonate, and the nurse should monitor the patient closely if the patient receives therapy. A patient with renal dysfunction on dialysis Renal |
| A nurse is caring for a patient who takes calcium carbonate and was recently prescribed ciprofloxacin, a quinolone, for a urinary tract infection. Which teaching point would the nurse share with this patient about administration of these drugs? These t | Take calcium carbonate 1 to 2 hours after ciprofloxacin. |
| A patient who takes an antacid frequently for persistent heartburn presents with confusion and extreme muscle weakness. The patient is also having difficulty speaking. Which antacid would a nurse suspect this patient may have been receiving in excess? | Aluminum hydroxide |
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adricela55