Acid Reducing Meds Pharmacology #2

Question

Which medication(s) does the nurse expect the healthcare provider to order for a client’s new gastroesophageal reflux disease symptoms?

Select all that apply.

Answers

  1. Lactulose
    • Rationale:

      This answer is not correct because lactulose is laxative and ammonia reduce in clients with elevated ammonia levels, which can produce hepatic encephalopathy. This medication is not indicated for treatment of GERD symptoms and would not be expected to be prescribed by the provider.

  2. Ranitidine
    • Rationale:

      This answer is correct because ranitidine is a histamine (H2) receptor antagonist, which is commonly used to combat symptoms of GERD in clients. This class of medication works to suppress gastric acid secretion by blocking H2 receptors of the parietal cells, the acid producing cells in the stomach.

  3. Amoxicillin
    • Rationale:

      This answer is not correct because amoxicillin is an antibiotic. It is often used for treatment of Helicobactor pylori, a bacteria associated with peptic ulcers. This would not be prescribed for GERD symptoms.

  4. Esomeprazole
    • Rationale:

      This answer is correct because esomeprazole is a proton pump inhibitor, which is commonly used to treat symptoms of GERD in clients. This class of medication works to suppress acid in the stomach by inhibiting enzymes that make gastric acid in the stomach, thereby decreasing symptoms of GERD.

  5. Misoprostol
    • Rationale:

      This answer is not correct because misoprostol is a synthetic prostaglandin used to treat peptic ulcer disease in clients associated with long-term use of steroids and non-steroidal anti inflammatory medications. This medication should never be used in a pregnant client unless delivery of the fetus is desired. This medication is also used for cervical ripening and if used, delivery is imminent.

Overview

Proton pump inhibitors (PPIs) (i.e., esomeprazole) and histamine (H2) receptor antagonists (i.e., ranitidine) are commonly prescribed for prevention of gastroesophageal reflux disease (GERD). Recognizing and understanding their indications is an important duty of the nurse.

Explanation

Learning Outcomes

Gastroesophageal reflux disease (GERD) has symptoms including belching, regurgitation, heartburn, bitter taste, or dry cough. These symptoms are often treated with PPIs and H2 receptor antagonists. GERD can lead to Barrett’s esophagus and esophageal cancer so it needs to be treated promptly and consistently. Medication classes such as PPIs and H2 receptor antagonists work to suppress acid secretion within the stomach, thereby decreasing symptoms of GERD.

Test Taking Tip

A psychological technique used to boost your test-taking confidence is to look into a mirror whenever you pass one and say out loud, “I know the material, and I’ll do well on the test.” Try it; many students have found that it works because it reduces “test anxiety.”

Video Rationale