Medical Condition
Drug
Brand & Generic
Expected Drug Action and Pregnancy Category
Dosing
Adverse Drug Reactions
Drug Interactions
Monitoring
Patient Education

GERD

TUMS/ Calcium carbonate
Neutralizes gastric acidity
Pregnancy C
500mg chew 2-4 tablets not to exceed 15tabs/24hr
Nausea, vomiting, constipation, flatulence, anorexia, hypercalcemia, hypophospatemia
CCB decrease esophageal sphincter pressure
Decreased action of fluoroquinolones, hydantoins, iron salts, tetracyclines, atenolol
Ca++, with long term use, assess GI and renal status,
Adverse effects
Take 1 hr before or 2 after other meds
Chew completely and follow with 8 oz of water
Notify HCP is constipation or bloody diarrhea develops
Discard out-of-date antacids
Do not use longer than 2 weeks

Rationale for drug choice: this drug therapy for GERD is antacid prior to prescriptions meds. They are available OTC, easy access and cost-effective. They are immediate release. If ineffective, PPIs or H2 blockers are prescribed. Start low and go slow.

Constipation

Metamucil/ Psyllium
Bulk producing laxative
Pregnancy B
1 tsp in 8 oz H2O by mouth daily
Abdominal distention, bloating, flatulence, impaction
Sodium picosulfate-decreases effects
Monitor for obstruction,symptoms of appenditcitis,Acute abdomen, GI ulceration, dysphasia, rectal bleed
Increase fluids and add roughage (fiber) to diet.

Rationale for drug choice: Bulk forming laxatives are first line treatment for constipation.

Motion Sickness

Scopolamine patch/ transderm scop
Prevents motion induced nausea by blocking transmission of cholinergic impulse from vestibular nuclei to higher centers in CNS and from reticular formation to vomiting center
Pregnancy C
1mg/72hr transdermal patch
Dry mouth, drowsiness, dizziness, blurred vision, itching
Potassium
Benzodiazepines, muscle relaxants, and narcotics increase effects antihistamines Increased ocular pressure, bp, mental status

Use caution when driving or operating machinery. Store at room temperature. Properly discard of patch, do not wear more than one at a time. Be careful outside, this decreases the ability to sweat.
Drink plenty of fluids
Rationale for drug choice:

Peptic Ulcer Disease

Pepcid/ Famotidine
Blocks H2 receptors of gastric parietal cells leading to inhibition of gastric secretions
Pregnancy B
20mg po daily
Headache, diarrhea, dizziness, constipation
Warfarin can inc/dec PT.
Cefuroxime, ketonazole, itraconazole decr. absorbtion
Cr at baseline monitor cbc& PLt.
Take medication after meals and at HS. Reportto your HCP blood in vomit or stool, tiredness, weakness, do not take within 2 hrs of antacids
Rationale for drug choice: Famotidine is approximately 7.5 times more potent than rantidine and 20 times more