Advanced Pharmacology Care of the
Fundamentals Exam | Questions and
Quiz__________?
Antacids ADRs and contraindications -
Answer✅
Magnesium containing products, especially Milk of Magnesia, can cause diarrhea.
Constipation can result from both the aluminum- and calcium-containing formulations. The
combination of aluminum and magnesium hydroxide is favored because the side effects are
then decreased. Kidney stones can develop from the calcium products. Systemic alkalosis
can result from extreme antacid use, which primarily occurs with sodium bicarbonate use.
Excess sodium, which is present in some antacid preparations, can worsen hypertension and
heart failure. Patients with these conditions should avoid the formulations that have high
sodium content. Rebound hyperacidity, or acid rebound is an adverse effect the patient
experiences with the discontinuation of antacids. This adverse effect mainly occurs with
calcium-containing products. Serious diseases, such as cancer or bleeding ulcers, may be
masked with long-term antacid use. Therefore, ongoing symptoms must be checked and
evaluated because other medical interventions may be required.
Quiz__________?
Antacids Clinical indications & dosing -
Answer✅
Peptic ulcer disease (PUD) is the primary indication for antacid use. The healing rates are
equal to that of H2RAs. In the past, antacids were primarily used for antiulcer therapy;
,however, newer options have replaced these drugs (H2RAs, PPIs, sucralfate) that are just as
beneficial and effective, with easier administration, and cause fewer side effects. Aspiration
pneumonitis is prevented by antacid administration before anesthesia. In addition,
medication can be used to prevent and treat stress-induced ulcers. GERD patients can have
relief from antacid use, but unfortunately, healing is not accelerated. Even though antacid use
is generally used by the public, there are no studies that show the effectiveness of antacid
use for symptoms such as dyspepsia, heartburn, and indigestion. It is essential for the nurse
to administer antacids appropriately, follow accurate dosing parameters, and properly
monitor lab values closely to avoid adverse effects. Before administering, shake suspension
well and follow with water. Due to the delay in other drug absorption, antacid
administration should be avoided with other oral drugs. Antacids should not be given with
tetracycline, digoxin, or quinidine, because it binds with and inactivates most of the drug.
Therefore, antacids should be given 1 to 2 hours after other medications. Monitor
electrolytes, urinary pH, calcium, and phosphate levels after antacid administration. Drug
(Pregnancy Category) aluminum hydroxide (Amphojel) (A) aluminum hydroxide and
magnesium hydroxide (Maalox, Mylanta) (A) calcium carbonate (Tums) (A) magnesium
hydroxide (milk of magnesia) (A) Pharmacologic Class Aluminum-containing antacid
Combination antacid Calcium-containing antacid Magnesium-containing antacid Usual Adult
Dosage Range Adult PO: 600-1500 mg 3-6 times per day Adult 400-2400 mg 3-6 times per
Quiz__________?
Antacids Patient Education -
Answer✅
Proper patient education regarding administration of antacids is important for the nurse and
patient. Below are some key points to include with the patient when teaching: Emphasize
the importance of taking antacids correctly. Tablets that are chewable must be completely
chewed and followed with water. Drink 2-4 ounces of water after taking the liquid antacid.
Gastric emptying time increases when the amount of water with antacids increases. Report
pain, coughing, or vomiting of blood. Take the antacid 1 to 3 hours after meals and at
bedtime. The patient does not need to take antacids at mealtime; they slow gastric emptying
time, causing increased GI activity and gastric secretions. Taking an unlimited amount of the
antacid is contraindicated. Do not take the antacids with milk or foods high in vitamin D.
Avoid taking antacids within 1 to 2 hours of other oral medications, because they may
interfere with absorption. Follow a sodium-restricted diet and monitor antacid labels for
sodium content.C onsult with their health care provider before taking antacids for longer
than 2 weeks. Guide patient on the use of relaxation techniques.
Quiz__________?
Antacids Pharmacodynamics -
, Answer✅
Neutral salts or low-acidic salts are produced when gastric acid reacts with antacids. The
destruction of the stomach's wall is lowered when these drugs neutralize the acid in this
location. With antacid use, pepsin activity may be decreased if the gastric pH is increased
above 5. Additionally, prostaglandin production is accelerated with antacid use, which can
strengthen mucosal protection. It is important to note that antacids do not place a
protective barrier or coating over the ulcer from pepsin or acid. Antacid absorption is poor,
with the exception of sodium bicarbonate, thus, systemic pH is not modified.
Quiz__________?
Antacids Pharmacokinetics -
Answer✅
renally eliminated
Quiz__________?
Antacids Pharmacotherapeutics -
Answer✅
severe renal failure, and GI obstruction. The four basic antacid mechanisms that cause
interactions are: Absorption of other drugs to antacids, which reduces the ability of the
other drug to be absorbed into the body. Chelation, which is the chemical inactivation of
other drugs that produces insoluble complexes Increased stomach pH, which increases the
absorption of basic drugs and decreases the absorption of acidic drugs. Increased urinary
pH, which increases the excretion of acidic drugs and decreases the excretion of basic
drugs. Most drugs are either weak acids or weak bases. Therefore, pH conditions in both
the GI and urinary tracts will affect the extent to which drug molecules are absorbed.
Benzodiazepines, sulfonylureas, sympathomimetic acid, and valproic acid are drugs that may
be chemically enhanced by antacid presence (due to the effects of pH). The efficacy of other
drugs, such as anticonvulsants (e.g., phenytoin sodium), is reduced when antacids are
present because antacids impede the GI absorption of the drugs. When the quinolone
antibiotics (ciprofloxacin, levofloxacin, moxifloxacin), which are orally administered to treat
serious infections, are given with antacids, severe harm may occur to a patient because
antacids can reduce absorption of the antibiotics by more than 50%.
Quiz__________?
Antidiarrheal Clinical Pearl -
Fundamentals Exam | Questions and
Quiz__________?
Antacids ADRs and contraindications -
Answer✅
Magnesium containing products, especially Milk of Magnesia, can cause diarrhea.
Constipation can result from both the aluminum- and calcium-containing formulations. The
combination of aluminum and magnesium hydroxide is favored because the side effects are
then decreased. Kidney stones can develop from the calcium products. Systemic alkalosis
can result from extreme antacid use, which primarily occurs with sodium bicarbonate use.
Excess sodium, which is present in some antacid preparations, can worsen hypertension and
heart failure. Patients with these conditions should avoid the formulations that have high
sodium content. Rebound hyperacidity, or acid rebound is an adverse effect the patient
experiences with the discontinuation of antacids. This adverse effect mainly occurs with
calcium-containing products. Serious diseases, such as cancer or bleeding ulcers, may be
masked with long-term antacid use. Therefore, ongoing symptoms must be checked and
evaluated because other medical interventions may be required.
Quiz__________?
Antacids Clinical indications & dosing -
Answer✅
Peptic ulcer disease (PUD) is the primary indication for antacid use. The healing rates are
equal to that of H2RAs. In the past, antacids were primarily used for antiulcer therapy;
,however, newer options have replaced these drugs (H2RAs, PPIs, sucralfate) that are just as
beneficial and effective, with easier administration, and cause fewer side effects. Aspiration
pneumonitis is prevented by antacid administration before anesthesia. In addition,
medication can be used to prevent and treat stress-induced ulcers. GERD patients can have
relief from antacid use, but unfortunately, healing is not accelerated. Even though antacid use
is generally used by the public, there are no studies that show the effectiveness of antacid
use for symptoms such as dyspepsia, heartburn, and indigestion. It is essential for the nurse
to administer antacids appropriately, follow accurate dosing parameters, and properly
monitor lab values closely to avoid adverse effects. Before administering, shake suspension
well and follow with water. Due to the delay in other drug absorption, antacid
administration should be avoided with other oral drugs. Antacids should not be given with
tetracycline, digoxin, or quinidine, because it binds with and inactivates most of the drug.
Therefore, antacids should be given 1 to 2 hours after other medications. Monitor
electrolytes, urinary pH, calcium, and phosphate levels after antacid administration. Drug
(Pregnancy Category) aluminum hydroxide (Amphojel) (A) aluminum hydroxide and
magnesium hydroxide (Maalox, Mylanta) (A) calcium carbonate (Tums) (A) magnesium
hydroxide (milk of magnesia) (A) Pharmacologic Class Aluminum-containing antacid
Combination antacid Calcium-containing antacid Magnesium-containing antacid Usual Adult
Dosage Range Adult PO: 600-1500 mg 3-6 times per day Adult 400-2400 mg 3-6 times per
Quiz__________?
Antacids Patient Education -
Answer✅
Proper patient education regarding administration of antacids is important for the nurse and
patient. Below are some key points to include with the patient when teaching: Emphasize
the importance of taking antacids correctly. Tablets that are chewable must be completely
chewed and followed with water. Drink 2-4 ounces of water after taking the liquid antacid.
Gastric emptying time increases when the amount of water with antacids increases. Report
pain, coughing, or vomiting of blood. Take the antacid 1 to 3 hours after meals and at
bedtime. The patient does not need to take antacids at mealtime; they slow gastric emptying
time, causing increased GI activity and gastric secretions. Taking an unlimited amount of the
antacid is contraindicated. Do not take the antacids with milk or foods high in vitamin D.
Avoid taking antacids within 1 to 2 hours of other oral medications, because they may
interfere with absorption. Follow a sodium-restricted diet and monitor antacid labels for
sodium content.C onsult with their health care provider before taking antacids for longer
than 2 weeks. Guide patient on the use of relaxation techniques.
Quiz__________?
Antacids Pharmacodynamics -
, Answer✅
Neutral salts or low-acidic salts are produced when gastric acid reacts with antacids. The
destruction of the stomach's wall is lowered when these drugs neutralize the acid in this
location. With antacid use, pepsin activity may be decreased if the gastric pH is increased
above 5. Additionally, prostaglandin production is accelerated with antacid use, which can
strengthen mucosal protection. It is important to note that antacids do not place a
protective barrier or coating over the ulcer from pepsin or acid. Antacid absorption is poor,
with the exception of sodium bicarbonate, thus, systemic pH is not modified.
Quiz__________?
Antacids Pharmacokinetics -
Answer✅
renally eliminated
Quiz__________?
Antacids Pharmacotherapeutics -
Answer✅
severe renal failure, and GI obstruction. The four basic antacid mechanisms that cause
interactions are: Absorption of other drugs to antacids, which reduces the ability of the
other drug to be absorbed into the body. Chelation, which is the chemical inactivation of
other drugs that produces insoluble complexes Increased stomach pH, which increases the
absorption of basic drugs and decreases the absorption of acidic drugs. Increased urinary
pH, which increases the excretion of acidic drugs and decreases the excretion of basic
drugs. Most drugs are either weak acids or weak bases. Therefore, pH conditions in both
the GI and urinary tracts will affect the extent to which drug molecules are absorbed.
Benzodiazepines, sulfonylureas, sympathomimetic acid, and valproic acid are drugs that may
be chemically enhanced by antacid presence (due to the effects of pH). The efficacy of other
drugs, such as anticonvulsants (e.g., phenytoin sodium), is reduced when antacids are
present because antacids impede the GI absorption of the drugs. When the quinolone
antibiotics (ciprofloxacin, levofloxacin, moxifloxacin), which are orally administered to treat
serious infections, are given with antacids, severe harm may occur to a patient because
antacids can reduce absorption of the antibiotics by more than 50%.
Quiz__________?
Antidiarrheal Clinical Pearl -
