Chapter 35 Drug Therapy for Peptic Ulcer Disease


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Chapter 35  Drug Therapy for Peptic Ulcer Disease



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Sample Questions



1. A patient is taking nonsteroidal anti-inflammatory agents for arthritis of the knees and hips. Which of the following diseases is a result of cellular destruction of the gastrointestinal tract from this medication?

  1. A)  Esophageal cancer
  2. B)  Bowel obstruction
  3. C)  Liver cancer
  4. D)  Peptic ulcer disease

Ans: D


Cell destruction will occur from the ingestion of NSAIDs, which can lead to the development of peptic ulcer disease. Nonsteroidal anti-inflammatory agents do not cause esophageal cancer, bowel obstruction, or liver cancer.

2. A patient has Maalox ordered for administration as needed. Which of the following conditions contraindicates the administration of Maalox?

  1. A)  Hypertension
  2. B)  Heart rate of 68
  3. C)  Renal dysfunction
  4. D)  Stress ulcer

Ans: C
Magnesium-based antacids are contraindicated in patients with renal failure. Magnesium-based antacids are not contraindicated with hypertension, regular heart rate, or stress ulcer.

3. A patient is diagnosed with peptic ulcer disease complicated by H. pylori. What is the rationale for adding bismuth to the patient’s medication regimen?

  1. A)  Increases pepsin activity
  2. B)  Decreases gastrin secretion
  3. C)  Prevents metabolic alkalosis
  4. D)  Protects gastric mucosa from stomach acid

Ans: D
Health care providers use bismuth subsalicylate to coat ulcers, protecting them from stomach acid to treat H. pylori. Bismuth does not increase pepsin activity, decrease gastrin secretion, or prevent metabolic alkalosis.

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4. A patient is in the intensive care unit and being administered ranitidine (Zantac) parenterally. How long will it take for ranitidine (Zantac) to reach peak blood levels?

  1. A)  15 minutes
  2. B)  30 minutes
  3. C)  1 hour
  4. D)  2 hours

Ans: A
Parenteral ranitidine reaches peak blood level in 15 minutes. Parenteral ranitidine reaches its peak prior to 30 minutes, 1 hour, and 2 hours.

5. The nurse practitioner instructs the patient to use over-the-counter ranitidine (Zantac) instead of cimetidine (Tagamet). What risk is decreased when using ranitidine rather than cimetidine?

  1. A)  Headache
  2. B)  Drug-to-drug interaction
  3. C)  Diarrhea
  4. D)  Bradycardia

Ans: B


Unlike cimetidine, ranitidine (Zantac), famotidine (Pepcid, Pepcid RPD), and nizatidine (Axid) do not affect the cytochrome P450 drug-metabolizing system in the liver and therefore do not interfere with the metabolism of other drugs. Use of these other drugs may be preferable in patients who are critically ill because they often require numerous other drugs with which cimetidine may interact.

6. A patient is taking cimetidine (Tagamet) for increased gastric pain and hypersecretion. Nurses should use extreme caution when administering cimetidine to patients with which of the following conditions?

  1. A)  Hepatic disease
  2. B)  Cancer
  3. C)  Hypertension
  4. D)  Diabetes mellitus

Ans: A
No absolute contraindications exist, but cimetidine should be used cautiously in patients with impaired hepatic and renal function. The patient with cancer, hypertension, and diabetes mellitus can take cimetidine safely.

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