Best given 1 hour before meals on empty stomach and at bedtime 1 2 hours

-Best given 1 hour before meals (on empty stomach) and at bedtime & 1-2 hoursbefore/after other medsNursing Process:Assessment:Complete a thorough assessment including health history and pharmacologichistory.Pay close attention to hepatic & renal function. For patients using H2 receptorantagonist drugs, assess renal and liver function, as well as level of consciousness, because ofpossible drug-related adverse effects.Older adult patients are known to react to these drugswith more disorientation and confusion. For PPIs, assess swallowing capacity because of the sizeof some of the oral capsules.Diagnosis: Deficient knowledge related to lack of familiarity with prescribed medications, theiruse, and their adverse effectsPlanning: Patient reports appropriate use of prescribed medication with minimalcomplications/adverse effects and is able to state the drug's rationale, action, and therapeuticeffects by the end of shift.Implementation: Educate patient on use of medication, adverse effects and what to report tothe physician. When giving the chewable acid-controlling drugs, instruct the patient tothoroughly chew these tablets. Liquid forms need to be shaken thoroughly before administered.Antacids need to be given with at least 8 ounces of water to enhance absorption of the antacidin the stomach, except for newer dosage forms that are rapidly dissolving drugs. For allH2receptor antagonists, monitor blood pressure readings as needed during intravenous infusion,because of the risk for hypotension. Continue to monitor the patient for GI tract bleeding withthe diagnosis of ulcers or GI irritation. Report any blood in the stools or the occurrence of black,tarry stools or hematemesisEvaluation: Patient discussed use of prescribed medication, adverse effects, therapeutic effectsby the end of shift.

Key Points:• The stomach secretes many substances (hydrochloric acid, pepsinogen, mucus, bicarbonate,intrinsic factor, & prostaglandins).• The parietal cell is responsible for the production of acid.• In acid-related disorders, there is an impairment of the balance among the substancessecreted by the stomach.• H2 receptor antagonists are H2 blockers that bind to and block histamine receptors located onparietal cells. This blockade renders these cells less responsive to stimuli and thus decreasestheir acid secretion. Up to 90% inhibition of acid secretion can be achieved with the H2 receptorantagonists.• PPIs block the final step in the acid production pathway, the hydrogen–potassium-ATPasepump, and they block all acid secretion.• Sucralfate is used for the treatment of peptic ulcer disease and stress-related ulcers. It bindsto tissue proteins in the eroded area and prevents exposure of the ulcerated area to stomachacid.