A client with hepatitis C has been experiencing symptoms of gastroesophageal reflux.
What H antagonist would be most appropriate for this client’s needs?
Nizatidine.
Ranitidine.
Cimetidine.
Famotidine.
The Correct Answer is D
Famotidine is a histamine type 2 receptor antagonist (H blocker) which is commonly used for treatment of acid-peptic disease and heartburn. Famotidine has been linked to rare instances of clinically apparent acute liver injury, but it is less likely to cause hepatotoxicity than cimetidine, another H blocker. Famotidine also has fewer drug interactions than cimetidine.
Choice A is wrong because nizatidine is another H blocker that can cause mild and transient serum aminotransferase elevations.
Nizatidine has not been linked to cases of clinically apparent liver injury, but it has not been widely used.
Choice B is wrong because ranitidine is another H blocker that can cause mild and transient serum aminotransferase elevations.
Ranitidine has also been associated with rare instances of clinically apparent liver injury, some of which were fatal or required liver transplantation.
Choice C is wrong because cimetidine is another H blocker that can cause mild and transient serum aminotransferase elevations.
Cimetidine has also been implicated in several cases of clinically apparent acute liver injury, some of which were severe and led to acute liver failure and death.
Cimetidine also has many drug interactions due to its inhibition of cytochrome P enzymes.
Normal ranges for serum aminotransferases are 7 to 56 U/L for alanine aminotransferase (ALT) and 10 to 40 U/L for as
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is A
Explanation
800 mg PO at bedtime is an appropriate dosage and frequency of cimetidine for the treatment of gastric ulcer. Cimetidine is a histamine H antagonist that reduces the secretion of gastric acid.
Choice B is wrong because 150 mg PO b.i.d. is too low of a dose for cimetidine. The usual adult dose for duodenal ulcer is 800 mg PO once a day at bedtime or 300 mg PO four times a day.
Choice C is wrong because 20 mg PO b.i.d. is not a valid dose for cimetidine.
The lowest available tablet strength is 100 mg.
Choice D is wrong because 300 mg PO at bedtime is also too low of a dose for cimetidine.
The usual adult dose for gastric ulcer is 800 mg PO once a day at bedtime or 300 mg PO four times a day.
Correct Answer is C
Explanation
The nurse should advise the client to avoid aluminum salts because they can increase the risk of aluminum toxicity when taken with sucralfate. Sucralfate forms a protective coating over the ulcer and binds to aluminum in the stomach.
Choice A is wrong because Milk of Magnesia is a magnesium-based antacid that can cause diarrhea, but does not interact with sucralfate.
Choice B is wrong because Calcium carbonate is a calcium-based antacid that can cause constipation, but does not interact with sucralfate.
Choice D is wrong because Proton pump inhibitors are drugs that reduce the production of stomach acid and can help heal ulcers.
They do not interact with sucralfate.
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