ACTIVE LEARNING TEMPLATES
Medication
STUDENT NA ME _____________________________________
MEDICATION __________________________________________________________________________ REVIEW MODULE CHAPTER ___________
CAT EGO RY CL ASS ______________________________________________________________________
ACTIVE LEARNING TEMPLATE:
PURPOSE OF MEDICATION
Expected Pharmacological Action
Complications
Contraindications/Precautions
Interactions
Medication Administration
Evaluation of Medication Effectiveness
Therapeutic Use
Nursing Interventions
Client Education
References:
Vallerand, A.H. & Sanoski, C.A. (2019). Davis’s drug guide for nurses (16th Ed.). Philadelphia, PA: Elsevier.
Alexis Jimenez
Esomeprazole
proton-pump inhibitors
-Binds to an enzyme on gastric parietal cells in the
presence of acidic gastric pH, preventing the final
transport of hydrogen ions into the gastric lumen.
Gastroesophageal Reflux Disease
-PO (Adults): Healing erosive esophagitis- 20 mg or 40 mg
once daily for 4-8 wk; Maintenance of healing of erosive
esophagitis- 20 mg once daily; Symptomatic GERD- 20 mg
once daily for 4 wk (additional 4 wk may be considered for
nonresponders); Heart burn- 20 mg once daily for 2 wk.
-PO (children 12-17 yr): Short-term treatment of GERD- 20-40
mg once daily for up to 8 wk.
-PO (children 1-11 yr): Short-term treatment of GERD- 10 mg
once daily for up to 8 wk; Healing of erosive esophagitis- >20
kg: 10 mg once daily for 8 wk; less than or equal to 20 kg:
10-20 mg once daily for 8 wk.
-PO: Administer at least 1 hr before meals. Swallow tablets and
capsules whole.
Drug-Drug: May significantly decrease levels of rilpivirine, concurrent use contraindicated. May decrease levels of atazanavir and
nelfinavir; avoid concurrent use with either of these antiretrovirals. May increase levels and risk of toxicity of saquinavir (may need
to decrease dose of saquinavir). May decrease absorption of drugs requiring acid pH, including ketoconazole, itraconazole,
ampicillin esters, iron salts, erlotinib, and mycophenolate mofetil. May increase levels of digoxin and methotrexate. May increase
risk of bleeding with warfarin (monitor INR and PT). Voriconazole may increase levels. May decrease the antiplatelet effects of
clopidogrel; avoid concurrent use. May increase levels of cilostazol; consider decreasing dose of cilostazol from 100 mg twice daily
to 50 mg twice daily. Rifampin may decrease levels and may decrease response (avoid concurrent use). Hypomagnesemia
increases risk of digoxin toxicity. May increase levels of tacrolimus and methotrexate.
Drug-Natural Products: St. John's may decrease levels and may decrease response (avoid concurrent use).
Contraindicated in: Hypersensitivity to esomeprazole or related drugs
(benzimidazoles); Hypersensitivity; Concurrent use of rilpivirine.
Use Cautiously in: Severe hepatic impairment; Patients using high-doses for >
1 yr (increased risk of hip, wrist, or spine fractures and fundic gland polyps);
Patients using therapy for > 3 yr (increased risk of vitamin B12 deficiency);
OB, Lactation: USe only if potential benefit outweighs potential risk.
CNS: headache. Derm: cutaneous lupus erythematosus. F and E:
hypomagnesemia (especially if treatment duration greater than or equal to 3 mo).
GI: Clostridium difficile-associated diarrhea (CDAD), abdominal pain, constipation,
diarrhea, dry mouth, flatulence, fundic gland polyps, nausea. GU: acute interstitial
nephritis. Hemat: vitamin B12 deficiency. MS: bone fracture. Misc: systemic lupus
erythematosus.
-Diminished accumulation of acid in the gastric lumen with
lessened gastroesophageal reflux.
-Healing duodenal ulcers.
-Decreased incidence of gastric ulcer during continuous NSAID
therapy.
-Assess routinely for epigastric
abdominal pain and frank or occult blood
in the stool, emesis, or gastric aspirate.
-Monitor bowel function.
-Monitor serum magnesium prior to and
periodically during therapy.
-Do not confuse Nexium with Nexavar.
-Decrease in abdominal pain or prevention of gastric irritation and bleeding. Healing of
duodenal ulcers can be seen on x-ray examination or endoscopy.
-Decrease in symptoms of GERD and erosive esophagitis. Sustained resolution of symptoms
usually occurs in 5-8 days. Therapy is continued for 4-8 wk after initial episode.
-Decreased incidence of gastric ulcer during continuous NSAID therapy.
-Eradication of H. pylori in duodenal ulcer disease.
-Decrease in symptoms of hypersecretory conditions including Zollinger-Ellison.
-Instruct patient to take medication as directed for
the full course of therapy, even if feeling better.
-Advise patient to avoid alcohol, products containing
aspirin or NSAIDs, and foods that that may cause
an increase in GI irritation.
-Advise patient to report onset of black, tarry stools.
-Advise patient to notify health care professional if
signs of hypomagnesemia occur.
-Caution patient to notify health care professional if
fever and diarrhea occur, especially if stool contains
blood, pus, or mucus.
