Generic Brand Drug Mode of Action Indications Contraindications Actual Usual Dose Side Effects Nursing Responsibilities

Name Name Classification Dose

esomeprazole Nexium Antisecretor Gastric acid-pump GERD—treatment Contraindicated with IVTT Healing of CNS: CLINICAL ALERT!
magnesium , y drug inhibitor: Suppresses of heartburn and hypersensitivity to 40mg now erosive Headache, Potential for name
(perprazole, S- Nexium Proton pump gastric acid secretion other related omeprazole, then q esophagitis: 20– dizziness, confusion exists between
omeprazole) IV inhibitor by specific inhibition symptoms esomeprazole, or other 24hrs. 40 mg PO daily asthenia, esomeprazole and
of the hydrogen– proton pump inhibitor. for 4–8 wk. An vertigo, omeprazole; use caution.
potassium ATPase Erosive esophagitis additional 4–8 insomnia,
enzyme system at the —short-term (4–8 Use cautiously with wk course of apathy, 10R’s
secretory surface of wk) treatment for hepatic dysfunction, therapy can be anxiety,
the gastric parietal healing and pregnancy, lactation. considered for paresthesias, Assessment
cells; blocks the final symptom relief. Also patients who dream History: Hypersensitivity to
step of acid used for have not healed. abnormalities any proton pump inhibitor;
production; is broken maintenance therapy Dermatologic: hepatic dysfunction; pregnancy,
down less in the first following healing of Maintenance of Rash, lactation
pass through the liver erosive esophagitis healing erosive inflammation, Physical: Skin lesions; T;
than the parent esophagitis: urticaria, reflexes, affect; urinary output,
compound Short-term treatment 20 mg daily. pruritus, abdominal examination;
omeprazole, allowing of GERD with a alopecia, dry respiratory auscultation, LFTs
for increased serum history of erosive- Symptomatic skin
levels. esophagitis by IV GERD: 20 mg GI: Diarrhea, Interventions
route for up to 10 daily for 4 wk. abdominal WARNING: Arrange for
days, when oral An additional 4- pain, nausea, further evaluation of patient
therapy is not wk course of vomiting, after 4 wk of therapy for
possible. therapy can be constipation, gastroesophageal reflux
As part of considered if dry mouth, disorders. Symptomatic
combination therapy symptoms have tongue improvement does not rule out
for the treatment of not resolved. atrophy, gastric cancer.
duodenal ulcer flatulence If administering antacids, they
associated with Short-term Respiratory: may be administered
Helicobacter pylori treatment of URI concomitantly with
GERD when symptoms, esomeprazole.
Reduction in oral therapy is sinusitis, Administer IV for maximum of
occurrence of gastric not possible: 20– cough, 10 days; switch to oral form as
ulcers associated 40 mg IV by epistaxis soon as possible.
with continuous injection over at Ensure that the patient
NSAID use in least 3 min or IV swallows capsule whole; do not
patients at risk (> 60 infusion over crush, or chew; patients having
yr, history of gastric 10–30 min. difficulty swallowing may open
ulcers) for capsule and sprinkle in
developing gastric Duodenal ulcer: applesauce or disperse in tap
ulcers 40 mg/day PO water, orange or apple juice, or
for 10 days with yogurt; do not crush or chew
1,000 mg PO bid pellets.
ampicillin and Obtain baseline LFTs and
500 mg PO bid monitor periodically during
clarithromycin. therapy.
Maintain supportive treatment
Reduction of risk as appropriate for underlying
of gastric ulcers problem.
with NSAID use: Provide additional comfort
20–40 mg/day measures to alleviate
PO for 6 mo. discomfort from GI effects and
headache.
Establish safety precautions if
dizziness or other CNS effects
occur (use side rails,
accompany patient).