Buy a Nursing essay from nursingessays.us

Left your Nursing Assignment to the last minute? Let a qualified expert do your Nursing essay for you and deliver it before your deadline!

9.8
Buy Nursing essay Papers
Calculate your paper price
Pages (550 words)
Approximate price: -

Histamine-2 Antagonists

Histamine-2 (H2) receptor antagonists block the release of acid in response to gastrin or parasympathetic release.

Histamine-2 Antagonist: Generic and Brand Names

Here is a table of the most commonly used H2 antagonists.
Classification Generic name Brand name
Histamine-2 antagonists cimetidine Tagamet
ranitidine Zantac
famotidine Pepcid
nizatidine Axid

Description

Histamine-2 antagonists block the release of hydrochloric acid in response to gastrin.
  • These drugs include cimetidine (Tagamet), ranitidine (Zantac), famotidine (Pepcid), and nizatidine (Axid).

Therapeutic actions

The desired actions of H2 antagonists include the following:
  • Selectively block H2 receptors located on the parietal cells.
  • Prevents the release of gastrin, a hormone that causes local release of histamine (due to stimulation of histamine receptors), ultimately blocking the production of hydrochloric acid.
  • Decreases pepsin production by the chief cells.

Indication

Histamine-2 antagonists are indicated for the following:
  • Short-term treatment of active duodenal ulcer or benign gastric ulcer.
  • Treatment of pathological hypersecretory conditions such as Zollinger-Ellison syndrome (blocking the overproduction of hydrochloric acid that is associated with these conditions).
  • Prophylaxis of stress-induced ulcers and acute upper GI bleeding in critical patients (blocking the production of acid protects the stomach lining, which is at risk because of decreased mucus production associated with extreme stress).
  • Treatment of erosive gastroesophageal reflux (decreasing the acid being regurgitated into the esophagus will promote healing and decrease pain).
  • Relief of symptoms of heartburn, acid indigestion, and sour stomach.

Histamine-2 Antagonists|Pharmacokinetics

Cimetidine, ranitidine, and famotidine are available in oral and parenteral forms
Route Onset Peak Duration
Oral Varies 1-1.5 h 4-5 h
IM, IV Rapid 1-1.5 h 4-5 h
T 1/2: 2 hours
Metabolization: Liver
Excretion: Urine

Contraindications and Cautions

The contraindications and cautions when using H2 antagonists include:
  • Allergy. The H2 antagonists should not be used with known allergy to any drugs of this class to prevent hypersensitivity reactions.
  • Pregnancy or lactation. Caution should be used during pregnancy or lactation because of the potential for adverse effects on the fetus or nursing baby.
  • Hepatic or renal dysfunction. Caution should be used in patients with hepatic or renal dysfunction, which could interfere with drug metabolism and excretion.
  • Prolonged or continual use. Care should also be taken if prolonged or continual use of these drugs is necessary because they may be masking serious underlying conditions.

Adverse effects

The adverse effects associated with H2 antagonists are:
  • CNS: Dizziness, confusion, headache, somnolence.
  • Cardio: Cardiac arrhythmias, cardiac arrest.
  • GI: Diarrhea.
  • Reproductive: Impotence.
  • Skin: Rash.
  • Misc: Gynecomastia.

Interactions

Cimetidine, famotidine, and ranitidine can slow down the metabolism of the following drugs, leading to increased serum levels and possible toxic reactions:

Nursing Considerations

Nursing considerations for a patient using H2 antagonists include the following:

Nursing Assessment

Nursing assessment for a patient using H2 antagonists include:
  • Assess for possible contraindications and cautions: history of allergy to any H2 antagonists to prevent potential allergic reactions; impaired renal or hepatic function, which could affect the metabolism and excretion of the drug; a detailed description of the GI problem, including length of time of the disorder and medical evaluation to evaluate the appropriate use of the drug and possibility of underlying medical problems; and current status of pregnancy and lactation because of the potential for adverse effects on the fetus or newborn.
  • Perform a physical examination to establish baseline data before beginning therapy, determine effectiveness of the therapy, and evaluate for any adverse effects associated with drug therapy.
  • Inspect the skin for evidence of lesions or rash to monitor for adverse reactions.
  • Evaluate neurological status, including orientation and affect, to assess CNS effects of the drug and to plan for protective measures.
  • Assess cardiopulmonary status, including pulse, blood pressure, and electrocardiogram (if IV use is needed), to evaluate the cardiac effects of the drug.
  • Perform abdominal examination, including assessment of the liver, to establish a baseline and rule out underlying medical problem.
  • Monitor the results of laboratory tests, including liver and renal function tests, to predict changes in metabolism or excretion of the drug that might require dose adjustment.

Nursing Diagnosis and Care Planning

Nursing diagnosis related to the drug therapy might include the following:

Nursing Implementation with Rationale

Nursing interventions for patients using H2 antagonists include:
  • Ensure therapeutic levels. Administer drug with or before meals and at bedtime (exact timing varies with product) to ensure therapeutic levels when the drug is most needed.
  • Prevent serious toxicity. Arrange for decreased dose in cases of hepatic or renal dysfunction to prevent serious toxicity.
  • Monitor IV doses carefully. Monitor the patient continually if giving IV doses to allow early detection of potentially serious adverse effects, including cardiac arrythmias
  • Assess for potential drug-drug interactions. Assess the patient carefully for any potential drug-drug interactions if given in combination with other drugs because of the drugs effects on liver enzyme systems.
  • Provide patient’s comfort. Provide comfort, including analgesics, ready to access bathroom facilities, and assistance with ambulation, to minimize possible adverse effects.
  • Reorient patient thoroughly. Periodically reorient the patient and institute safety measures if CNS effects occur to ensure patient safety and improve and improve patient tolerance of the drug and drug effects.
  • Attend regular follow-ups. Arrange for regular follow-up to evaluate drug effects and the underlying problems.
  • Provide support. Offer support and encouragement to help patients cope with the disease and the drug regimen.
  • Educate the client. Provide patient teaching regarding drug name, dosage, and schedule for administration; importance of spacing administration appropriately as ordered; need for readily available access to bathroom; signs and symptoms of adverse effects and measures to minimize or prevent them.

Evaluation

Evaluation of a patient using H2 antagonists include:
  • Monitor patient response to the drug (relief of GI symptoms, ulcer healing, prevention of progression of ulcer).
  • Monitor for adverse effects (dizziness, confusion, hallucinations, GI alterations, cardiac arrhythmias, hypotension, gynecomastia).
  • Evaluate the effectiveness of the teaching plan (patient can name drug, dosage, adverse effects to watch for, and specific measures to avoid them).
  • Monitor the effectiveness of comfort measures and compliance with the regimen.

Practice Quiz: Histamine-2 Antagonists

Here’s a 5-item quiz for this Histamine-2 Antagonists study guide:

Exam Mode

In Exam Mode: All questions are shown but the results, answers, and rationales (if any) will only be given after you’ve finished the quiz.
Histamine-2 Antagonists

Practice Mode

Practice Mode: This is an interactive version of the Text Mode. All questions are given in a single page and correct answers, rationales or explanations (if any) are immediately shown after you have selected an answer. No time limit for this exam.

Practice Quiz: Histamine-2 Antagonists

Congratulations - you have completed Practice Quiz: Histamine-2 Antagonists. You scored %%SCORE%% out of %%TOTAL%%. Your performance has been rated as %%RATING%%
Your answers are highlighted below.

Text Mode

1. Which of the following best describes the method of action of medications, such as ranitidine (Zantac), which are used in the treatment of peptic ulcer disease? A. Neutralize acid B. Reduce acid secretions C. Stimulate gastrin release D. Protect the mucosal barrier 1. Answer: B. Reduce acid secretions.
  • Option B: Ranitidine is a histamine-2 receptor antagonist that reduces acid secretion by inhibiting gastrin secretion.
2. A client is to take one daily dose of ranitidine (Zantac) at home to treat her peptic ulcer. The nurse knows that the client understands proper drug administration of ranitidine when she says that she will take the drug at which of the following times? A. Before meals B. With meals C. At bedtime D. When pain occurs 2. Answer: C. At bedtime.
  • Option C: Ranitidine blocks secretion of hydrochloric acid. Clients who take only one daily dose of ranitidine are usually advised to take it at bedtime to inhibit nocturnal secretion of acid.
3. The nurse provides medication instructions to a client with peptic ulcer disease. Which statement, if made by the client, indicates the best understanding of the medication therapy? A. “The cimetidine (Tagamet) will cause me to produce less stomach acid.” B. “Sucralfate (Carafate) will change the fluid in my stomach.” C. “Antacids will coat my stomach.” D. “Omeprazole (Prilosec) will coat the ulcer and help it heal.” 3. Answer: A. “The cimetidine (Tagamet) will cause me to produce less stomach acid.”
  • Option A: Cimetidine (Tagamet), a histamine H2 receptor antagonist, will decrease the secretion of gastric acid.
  • Option B: Sucralfate (Carafate) promotes healing by coating the ulcer.
  • Option C: Antacids neutralize acid in the stomach.
  • Option D: Omeprazole (Prilosec) inhibits gastric acid secretion.
4. When a client has peptic ulcer disease, the nurse would expect a priority intervention to be: A. Assisting in inserting a Miller-Abbott tube B. Assisting in inserting an arterial pressure line C. Inserting a nasogastric tube D. Inserting an I.V. 4. Answer: C. Inserting a nasogastric tube.
  • Option C: An NG tube insertion is the most appropriate intervention because it will determine the presence of active GI bleeding.
  • Option A: A Miller-Abbott tube is a weighted, mercury-filled ballooned tube used to resolve bowel obstructions.
  • Options B and D: There is no evidence of shock or fluid overload in the client; therefore, an arterial line is not appropriate at this time and an IV is optional.
5. A 40-year-old male client has been hospitalized with peptic ulcer disease. He is being treated with a histamine receptor antagonist (cimetidine), antacids, and diet. The nurse doing discharge planning will teach him that the action of cimetidine is to: A. Reduce gastric acid output. B. Protect the ulcer surface. C. Inhibit the production of hydrochloric acid (HCl). D. Inhibit vagus nerve stimulation. 5. Answer: A. Reduce gastric acid output.
  • Option A: These drugs inhibit the action of histamine on the H2 receptors of parietal cells, thus reducing gastric acid output.

References

Suggested reading and references for this Histamine 2 Receptor Antagonist Nursing Pharmacology Guide:
  • Lam, J. R., Schneider, J. L., Zhao, W., & Corley, D. A. (2013). Proton pump inhibitor and histamine 2 receptor antagonist use and vitamin B12 deficiency. Jama, 310(22), 2435-2442. [Link]
  • Karch, A. M., & Karch. (2011). Focus on nursing pharmacology. Wolters Kluwer Health/Lippincott Williams & Wilkins. [Link]
  • Katzung, B. G. (2017). Basic and clinical pharmacology. McGraw-Hill Education.
  • Lehne, R. A., Moore, L. A., Crosby, L. J., & Hamilton, D. B. (2004). Pharmacology for nursing care.
  • Smeltzer, S. C., & Bare, B. G. (1992). Brunner & Suddarth’s textbook of medical-surgical nursing. Philadelphia: JB Lippincott.

See Also

Here are other nursing pharmacology study guides: Gastrointestinal System Drugs Respiratory System Drugs Endocrine System Drugs Autonomic Nervous System Drugs Immune System Drugs Chemotherapeutic Agents Reproductive System Drugs Nervous System Drugs Cardiovascular System Drugs

Further Reading and External Links

Recommended resources and reference books. Disclosure: Includes Amazon affiliate links.
  1. Focus on Nursing Pharmacology - Easy to follow guide for Pharmacology
  2. NCLEX-RN Drug Guide: 300 Medications You Need to Know for the Exam - Great if you're reviewing for the NCLEX
  3. Nursing 2017 Drug Handbook (Nursing Drug Handbook) - Reliable nursing drug handbook!
  4. Lehne's Pharmacology for Nursing Care - Provides key information on commonly used drugs in nursing
  5. Pharmacology and the Nursing Process - Learn how to administer drugs correctly and safely!
  6. Pharm Phlash Cards!: Pharmacology Flash Cards - Flash Cards for Nursing Pharmacology
 

Questions?

Ask our team

Want to contact us directly? No problem. We are always here for you.

Frequently Asked Buy a Nursing essay Questions

See all
Is your service confidential?

When you place an order with our company, we ask you to provide us with such personal information as your name, phone number, and email address. We need this data to keep you updated on the important things related to your order or account, and never share it with any third parties. We also don’t use your contact details for spamming you.

Please note that our support team may contact you using only the phone number(s) stated on our website, such +1 (248) 599-2414 and/+44 (151) 528-2636. In order to secure our mutual cooperation, please do not communicate with those who introduce themselves as essaypapers support staff and reach you from different phone numbers.

Also, remember that we never ask you to provide your credit card information via phone conversations. You should enter this information only on PayPal or Gate2Shop billing forms when making an online payment on our website. The essaypapers support administrator will send a confirmation letter to your personal order page when your payment is received.

We also use a secure encrypted connection and do not store your private data if we do not need it anymore. For more details about how we ensure your confidentiality, check our Privacy Policy, which completely complies with the GDPR.

We offer original model papers that can be used legally in a number of ways if properly referenced:

  • As a source of arguments or ideas for your own research
  • As a source of additional understanding of the subject
  • Direct citing

Nonetheless, check your college’s/university’s policies, including their definition of plagiarism and paraphrasing before using our services. Make conscious decisions in regards to your education.

How do I order a paper from essaypapers?

We take care not only of your academic success, but also of your experience with us. That’s why we have made the process of placing your order as easy and fast as possible—usually, it takes no more than 2-3 minutes.

Let’s have a closer look at the simple steps you need to go through for submitting your order:

Fill in the order form.

Be sure to include specific instructions regarding your paper and to upload any of the required materials. If you have any questions while specifying your paper’s information, just click on the info sign at the end of every field name and you will see a detailed tip on what exact information is required.

Proceed with the payment.

After you are through with the order form, you will need to make a payment via a preferable system. Right after that, you will be automatically provided with your personal order page where you can track your order’s progress, provide additional requirements, and send messages to your writer or support manager.

A personal writer is assigned to your order.

Our qualified staff will choose the most suitable writer whose skills and experience match your field of study and paper’s details. In case the writer must have any particular software or literature in order to get the Nursing Assignment done, please do not forget to mention this in your initial instructions.

Your paper is completed and delivered to your personal order page.

When the writer finishes your paper, it is delivered to your personal order page as a PDF document, available for preview only. You will be able to download an editable MS Word version of the order right after you click the “Approve” button in the “Files” tab of your personal order page. If any changes are to be applied to the paper, you are always welcome to request a free revision with a new deadline for the writer (be sure to check more information about this in our revision policy).

You can check how easy the process is by going to the order page and submitting your paper details right now.

Is there a money-back guarantee? If yes, how can I receive a refund?

You can get more details about possible types and terms of refunds on our official money-back guarantee page.

How will I receive a completed paper?

You will get the first version of your paper in a non-editable PDF format within the deadline. You are welcome to check it and inform us if any changes are needed. If everything is okay, and no amendments are necessary, you can approve the order and download the .doc file. If there are any issues you want to change, you can apply for a free revision and the writer will amend the paper according to your instructions.

If there happen to be any problems with downloading your paper, please contact our support team.

What if I’m not satisfied with my order?

If your paper needs some changes, you can apply for a free revision that is available for 7 days after your paper is approved. To use this option, you have a “Revision” button on your personal page.

After the 7-day period, you cannot apply for a free revision, though you still can use a paid revision option. The price of such a revision will differ depending on the number of amendments needed to be done. Please contact our support team to find out how we can help you with the amendments to your paper.

If you think our writer didn’t manage to follow your instructions, and as a result, your paper is of poor quality, please contact us and we will do our best to solve the problem.

If the revisions didn’t give the desired result, you can apply for a refund. Our dispute department will process your inquiry to find out what kind of refund we can give you. To find out more, please visit our money-back guarantee page.

How do I request a refund?

You can’t apply for a refund on certain stages of your order, like when the order is not finished by the writer yet.

When the paper is delivered, the “Refund” button on your personal order page becomes clickable.

On the relevant tab of your personal order page, you will also be able to choose the type of refund you’re demanding and the reason why you applying for it. As soon as you do that, our dispute department will start working on your inquiry. All kinds of refunds concerning the quality or the lateness of your paper should be requested within 14 days from the time the paper was delivered, as in 14 days your paper, will be automatically approved.

Your inquiry should be submitted by clicking the “Refund” button on your personal order page only.

Order your essay today and save 15% with the discount code NURSINGHELP