Pharmacologic Class_H2 Receptor Antagonists (-tidine)_
Therapeutic Class _Anti-ulcer medication____________
Medications
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cimetidine (Tagamet)
rantidine (Zantac)
Action
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Inhibit histamine action on H2-receptors, which are found on the gastric parietal cells
Reduces secretion of gastric acid and H+ ion concentration
Effects
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↓ secretions of gastric acid, as well as H+ ion concentration  90% ↓
Indications
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Treatment of GERD, peptic ulcer disease and erosive esophagitis
Adjunct therapy in control of upper GI bleeding
Prevention and treatment of gastric and duodenal ulcers
Dyspnea
Side effects/adverse
effects
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DIARRHEA, constipation
CONFUSION and disorientation in elderly
Gynecomastia
Drug Interactions
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Smoking
Toxicity/Overdose
N/A
Contraindications
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Nursing Implications
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famotidine (Pepcid)
nizatidine (Axid)
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Thrombocytopenia
↓ in stomach acid may increase growth of
Candida and bacteria in stomach  in increased
risk of pneumonia
Caution w/ hepatic and renal dysfunction
Caution w/ older adults
Antacids can ↓ absorption, especially w/ cimetidine
Cimetidine has many drug interactions limit use
Oral meds may be taken w/o regard to meals
At least 1 hour should separate the administration of antacids and cimetidine
Teach pt to avoid alcohol
Smoking may ↓ effectiveness
Teach pt signs of gastric bleeding (black, tarry stools, “coffee ground” vomitus) and to notify health provider if any
occur
Teach pt to notify health care provider for any indication of respiratory problems
Teach pt that 5-6 small meals/day may be preferable to 3 large meals/day
Calcium-based and Aluminum-based are better for renal disease
Pregnancy category B