Page 1546 - Saunders Comprehensive Review For NCLEX-RN

depression, anxiety, and disorientation.

7. Dosage should be reduced in clients with renal

impairment.
8. Cimetidine inhibits hepatic drug-metabolizing
enzymes and can cause many medication levels to
rise; if administered with warfarin sodium,
phenytoin, theophylline, or lidocaine, the dosages of
these medications should be reduced.
C. Ranitidine
1. Can be administered orally, intramuscularly, or
intravenously
2. Side effects are uncommon, and it does not penetrate
the blood–brain barrier as cimetidine does.
3. Ranitidine is not affected by food.
D. Famotidine and nizatidine
1. Famotidine and nizatidine are similar to ranitidine
and cimetidine.
2. These medications do not need to be administered
with food.
IV. Proton Pump Inhibitors (Box 49-1)
A. Suppress gastric acid secretion
B. Used to treat active ulcer disease, erosive esophagitis, and
pathological hypersecretory conditions
C. Contraindicated in hypersensitivity
D. Common side effects include headache, diarrhea, abdominal pain,
and nausea.
V. Medication Regimens to Treat Helicobacter pylori Infections (Box 49-2)
A. An antibacterial agent alone is not effective for eradicating H.
pylori, because the bacterium readily becomes resistant to the
agent.
B. Triple or quadruple therapy with a variety of medication
combinations is used (if triple therapy fails, quadruple therapy is
recommended).
VI. Prokinetic Agent
A. Medication: Metoclopramide
B. Stimulates motility of the upper gastrointestinal tract and
increases the rate of gastric emptying without stimulating gastric,
biliary, or pancreatic secretions
C. Used to treat gastroesophageal reflux and paralytic ileus
D. May cause restlessness, drowsiness, extrapyramidal reactions,
dizziness, insomnia, and headache

E. Usually administered 30 minutes before meals and at

bedtime

F. Contraindicated in clients with sensitivity and in clients

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