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Pharmacologic class:乐动体育开户 Gastric acid pump inhibitor
Therapeutic class: Antiulcer drug
Pregnancy risk category B
Inhibits activity of proton pump in gastric parietal cells, decreasing gastric acid production
Capsules (delayed-release): 15 mg, 30 mg
Granules for oral suspension (delayed-release, enteric-coated):乐动体育开户 15 mg, 30 mg
Prevpac (combination product for Helicobacter pylori infection):乐动体育开户 daily pack containing two 30-mg lansoprazole capsules, four 500-mg amoxicillin capsules, and two 500-mg clarithromycin tablets
Prevacid NapraPAC 375 (combination product for reducing risk of ulcers from nonsteroidal anti-inflammatory drugs [NSAIDs]): weekly pack containing seven 15-mg Prevacid capsules and fourteen 375-mg Naprosyn tablets
Prevacid NapraPAC 500 (combination product for reducing risk of ulcers from NSAIDs):乐动体育开户 weekly pack containing seven 15-mg Prevacid capsules and fourteen 500-mg Naprosyn tablets
Prevacid SoluTab (delayed-release, orally disintegrating tablet): 15 mg, 30 mg
Indications and dosages
➣ Active duodenal ulcer
Adults: 15 mg P.O. daily for 4 weeks
➣乐动体育开户 Maintenance of healed duodenal ulcer
Adults: 15 mg P.O. daily
➣ H. pylori乐动体育开户 eradication, to reduce risk of duodenal ulcer recurrence
Adults:乐动体育开户 In triple therapy, 30 mg lansoprazole P.O., 1 g amoxicillin P.O., and 500 mg clarithromycin P.O. q 12 hours for 10 or 14 days. In dual therapy, 30 mg lansoprazole P.O. and 1 g amoxicillin P.O. q 8 hours for 14 days.
➣乐动体育开户 Benign gastric ulcer
Adults: 30 mg P.O. daily for up to 8 weeks
➣ Gastric ulcer associated with NSAIDs
Adults:乐动体育开户 30 mg P.O. once daily for up to 8 weeks
➣ To reduce risk of NSAID-associated gastric ulcer
Adults:乐动体育开户 15 mg P.O. daily for up to 12 weeks
➣ Gastroesophageal reflux disease
Adults and children ages 12 to 17: 15 mg P.O. daily for up to 8 weeks
Children ages 1 to 11 weighing more than 30 kg (66 1b):乐动体育开户 30 mg P.O. daily for up to 12 weeks
Children ages 1 to 11 weighing 30 kg (66 lb) or less: 15 mg P.O. daily for up to 12 weeks
➣ Erosive esophagitis
Adults and children ages 12 to 17:乐动体育开户 30 mg P.O. daily for up to 8 weeks. Some patients may require 8 additional weeks.
Children ages 1 to 11 weighing more than 30 kg (66 lb): 30 mg P.O. daily for up to 12 weeks
Children ages 1 to 11 weighing 30 kg (66 lb) or less:乐动体育开户 15 mg P.O. daily for up to 12 weeks
➣ To maintain healing of erosive esophagitis
Adults: 15 mg P.O. daily
➣ Pathologic hypersecretory conditions (including Zollinger-Ellison syndrome)
Adults: Initially, 60 mg P.O. daily, to a maximum of 90 mg P.O. b.i.d. Divide daily dosages over 120 mg.
➣ Frequent heartburn (two or more times a week)
Adults:乐动体育开户 15 mg P.O. (delayed-release capsule) daily up to 14 days
• Significant hepatic insufficiency
• Hypersensitivity to drug or its components
乐动体育开户Use cautiously in:
• phenylketonuria (orally disintegrating tablets), severe hepatic impairment
• elderly patients
• pregnant or breastfeeding patients
乐动体育开户• children younger than age 18.
• Give oral form before meals.
乐动体育开户• If patient has difficulty swallowing delayed-release capsule, open it and sprinkle contents onto small amount of soft food, such as applesauce or pudding. Don't crush or let patient chew drug.
乐动体育开户• When giving orally disintegrating tablet, place tablet on patient's tongue and let it disintegrate until particles can be swallowed.
• Know that orally disintegrating tablet contains phenylalanine.
乐动体育开户• When giving oral suspension, empty packet contents into container with 2 tbsp water. Stir contents well, and have patient drink immediately. Don't give oral suspension through nasogastric (NG) tube.
乐动体育开户• When injecting contents of delayed-release capsule through NG tube, open capsule and mix granules with 40 ml apple juice. Then rinse tube with additional apple juice to clear.
CNS: headache, confusion, anxiety, malaise, paresthesia, abnormal thinking, depression, dizziness, syncope, cerebrovascular accident
CV: chest pain, hypertension, hypotension, myocardial infarction, shock
EENT:乐动体育开户 visual field deficits, otitis media, tinnitus, epistaxis
GI: nausea, diarrhea, abdominal pain, cholelithiasis, ulcerative colitis, esophageal ulcer, hematemesis, stomatitis, dysphagia, GI hemorrhage
GU:乐动体育开户 renal calculi, erectile dysfunction, abnormal menses, breast tenderness, gynecomastia
Musculoskeletal: hip, wrist, spine fractures (with long-term daily use)
Respiratory: cough, bronchitis, asthma
Skin: urticaria, alopecia, acne, pruritus, photosensitivity
Drug-drug. Drugs requiring acidic pH (such as ampicillin esters, digoxin, iron salts, itraconazole, ketoconazole): decreased absorption of these drugs
Sucralfate:乐动体育开户 decreased lansoprazole absorption
Theophylline:乐动体育开户 increased theophylline clearance
Drug-food. Any food:乐动体育开户 decreased rate and extent of GI drug absorption
Drug-herbs. Male fern:乐动体育开户 inactivation of herb
St. John's wort: increased risk of photosensitivity
• Monitor for GI adverse reactions.
乐动体育开户• Assess nutritional status and fluid balance to identify significant problems.
• Instruct patient to take before meals.
• If patient has difficulty swallowing, tell him to open delayed-release capsule and sprinkle contents onto small amount of soft food (such as applesauce or pudding). Emphasize that he must not crush or chew drug.
• Tell patient to take orally disintegrating tablet by placing it on tongue and letting it disintegrate.
乐动体育开户• Instruct patient to take oral suspension by emptying packet contents into container with 2 tbsp water. Tell him to stir contents well and drink immediately.
• Advise patient to minimize GI upset by eating small, frequent servings of food and drinking plenty of fluids.
乐动体育开户• As appropriate, review all other significant and life-threatening adverse reactions and interactions, especially those related to the drugs, foods, and herbs mentioned above.
Prevacid 24 Hr(trade name)
ClassificationTherapeutic: antiulcer agents
Pharmacologic: proton pump inhibitors
Time/action profile (acid suppression)
|PO||rapid||1.7 hr||more than 24 hr|
Adverse Reactions/Side Effects
Central nervous system
- dizziness (most frequent)
- headache (most frequent)
- pseudomembranous colitis (life-threatening)
- diarrhea (most frequent)
- abdominal pain
Fluid and Electrolyte
- hypomagnesemia (especially if treatment duration ≥3 mo)
- bone fracture
Drug-Drug interactionSucralfate ↓ absorption of lansoprazole (take 30 min before sucralfate).May ↓ absorption of drugs requiring acid pH, including ketoconazole, itraconazole, atazanavirampicillin, iron salts, and digoxin.May ↑ risk of bleeding with warfarin (monitor INR/PT).Hypomagnesemia ↑ risk of digoxin toxicity.May ↑ methotrexate levels
Availability (generic available)
- Assess patient routinely for epigastric or abdominal pain and for frank or occult blood in stool, emesis, or gastric aspirate.
- Monitor bowel function. Diarrhea, abdominal cramping, fever, and bloody stools should be reported to health care professional promptly as a sign of pseudomembranous colitis. May begin up to several weeks following cessation of therapy.
- Lab Test Considerations: May cause abnormal liver function tests, including ↑ AST, ALT, alkaline phosphatase, LDH, and bilirubin.
- May cause ↑ serum creatinine and ↑ or ↓ electrolyte levels.
- May alter RBC, WBC, and platelet levels.
- May also cause ↑ gastrin levels, abnormal A/G ratio, hyperlipidemia, and ↑ or ↓ cholesterol.
- Monitor INR and prothrombin time in patients taking warfarin.
- May cause hypomagnesemia. Monitor serum magnesium prior to and periodically during therapy.
Potential Nursing DiagnosesAcute pain (Indications)
- Oral: Delayed-release capsules: Administer before meals. Swallow whole; do not crush or chew capsule contents. Capsules may be opened and sprinkled on 1 tbsp of applesauce, Ensure pudding, cottage cheese, yogurt or strained pears and swallowed immediately for patients with difficulty swallowing.
- For patients with an NG tube, capsules may be opened and intact granules may be mixed in 40 mL of apple juice and injected through the NG tube into stomach. Flush NG tube with additional apple juice to clear tube.
- Orally disintegrating tablets may be placed on tongue, allowed to disintegrate and swallowed with or without water. Do not cut or break tablet. For administration via oral syringe or nasogastric tube, Prevacid SoluTab can be administered by placing a 15-mg tablet in oral syringe and drawing up 4 mL of water, or a 30-mg tablet in oral syringe and drawing up 10 mL of water. Shake gently to allow for a quick dispersal. After tablet has dispersed, administer the contents within 15 minutes. Refill syringe with 2 mL (5 mL for the 30-mg tablet) of water, shake gently, and administer any remaining contents and flush nasogastric tube .
- Antacids may be used concurrently.
- Instruct patient to take medication as directed for the full course of therapy, even if feeling better. Take missed doses as soon as remembered unless almost time for next dose; do no double doses.
- May occasionally cause dizziness. Caution patient to avoid driving and other activities that require alertness until response to medication is known.
- Advise patient to avoid alcohol, products containing aspirin or NSAIDs, and foods that may cause an increase in GI irritation.
- Advise patient to report onset of black, tarry stools; diarrhea; or abdominal pain to health care professional promptly. Instruct patient to notify health care professional immediately if rash, diarrhea, abdominal cramping, fever, or bloody stools occur and not to treat with antidiarrheals without consulting health care professional.
- Instruct patient to notify health care professional of all Rx or OTC medications, vitamins, or herbal products being taken and consult health care professional before taking any new medications.
- Advise female patient to notify health care professional if pregnancy is planned or suspected or if breast feeding.
- Decrease in abdominal pain or prevention of gastric irritation and bleeding. Healing of duodenal ulcers can be seen on x-ray examination or endoscopy. Therapy is continued for at least 2–4 wk. Therapy for pathologic hypersecretory conditions may be long term.
- Healing in patients with erosive esophagitis. Therapy is continued for up to 8 wk, and an additional 8-wk course may be used for patients who do not heal in 8 wk or whose ulcer recurs.