magnesium hydroxide w/ aluminum hydroxide

(Maalox, Mylanta, Gaviscon)

• neurtalize gastric acid by forming a foamy layer around stomach contents
• for relief of symptoms of acute peptic ulcer, gastric hyperactivity, & heartburn
• SE:  diarrhea, constipation, hypophosphatemia,
• Monitor: serum phosphate, K⁺ (may be lower), & Ca⁺⁺ (may rise)
• do NOT use w/ bowel obstruction

• neutralixe gastric acidity and inactivates pepsin
• treat symptoms of peptic ulcer, gastritis, gastric hyperactivity & heartburn
• SE:  diarrhea, constipation, hypercalcemia, hypophosphatemia
• Monitor: serum phosphate, K⁺ (may lower), & Ca⁺⁺ (may rise)
• do NOT use w/ bowel obstruction

• ranitidne (Zantac)
• famotidine (Pepsid)
• nizatidine (Axid)

• block receptors of acid producing parietal cells
• treat PUD, GERD, erosive esophagitis, gastric hypersecretory conditions, & adjunct therapy for upper GI bleed
• SE: confusion, hypotention, depression, N/D, elevated liver enzymes
• Monitor: CBC w/ diff & stool for frank or occult blood
• may raise serum creatinine

• omeprazole (Prilosec)
• lansoprazole (Previcid)
• pantoprazole soduim (Protonix)

• irreversibly binds to proton pump
• treats erosive esophagitis, GERD, active duodenal ulcers, gastric hypersecretory conditions
• SE:  long term use can produce gastric tumors, predisposition of GI infections, add pain.
• drug-drug: may increase seum levels of diazepam & phenytoin, warfarin use increases chance of bleeding
• Monitor: CBC w/ diff, & INR, PTT for pt taking warfarin

• reduces gastric production at the pump

misoprostol (Cytotec): prostaglandin analog

• increases mucus production to protect gastric mucosa during NSAID therapy
• take w/ foods
• SE:  abd cramps, diarrhea, miscarriage
• Monitor: stool for frank / occult bleed

sucralfate (Carafate): mucosal barrier fortifier

• binds to ulcer surface, concentrates epidermal growth factor & stimulates mucoprotective molecules
• treats active stress ulcer, esophageal erosion, & long term PUD therapy
• take 1hr before meals and bedtime or 2hrs after meals
• SE:  aluminum toxicity, nausea, constipation, dry mouth
• Assess for frank / occult blood & abd pain

• inhibit bacterial protein synthesis
• part of combo therapy for H. pylori
• SE:  palpitations/ chest pain, dizziness, vertigo, N/V/D, heartburn, tinnitus, hearing loss, rash, headache
• may raise BUN, AST, ALT, & alkaline phosphatase
• assess stool for frank occult blood

• inhibit bacterial cell wall synthesis
• prevent/treat infection of susceptible organisms & mgt of ulcer disease caused by H.pylori
• SE:  rash, seizures, anaphylaxis
• Monitor: bowel function & s/s of anaphalaxis

• interrupts DNA & protein synthesis
• treat peptic ulcer caused by H.pylori & pseudomembranous colitis
• SE:  N/V, abd pain, dizziness, headache
• **do NOT use w/ alcohol **
• may alter AST, ALT, LDH results

• blocks effects of hisamine
• treatment of N/V
• SE:  confusion, sedation
• Monitor: CBC & serum glucose (may raise)
• may cause false positive pregnancy test

• inhibit peristalsis & reduces fecal volume
• treatment of diarrhea
• SE:  drowsiness, constipation
• Assess frequency & characteristics of stool, bowel sounds, & fluid & electrolyte balance