ANTIULCERANTS

Histamine-2
antagonists
 ANTIULCERANTS
• This group of drugs revolutionized
the prevention and treatment of
ulcer disease by providing marked
reduction in the production of
gastric acids.
• Familiar to most people as the over-
the counter heartburn medications
 Pharmacodynamics
• Histamine-2 antagonists block histamine-2
receptor sites in the gastric mucosa, thus
reducing secretion of gastric acids.

• The reduction in gastric acidity helps

treat or prevent peptic ulcer disease.
 Pharmacotherapeutics
• Prevention and treatment of gastric and
duodenal ulcers.

• Treatment of GERD and esophagitis.

• used to treat the precancerous condition of

Barrett's esophagus and gastroesophageal
reflux.

• used to treat Zollinger-Ellison syndrome and

multiple endocrine neoplasia.
 Pharmacokinetics
Pharmacokinetics
Absorption: 60% to 75% of oral amount.
Unknown after IM use
Distribution: to many body tissues.
Metabolism: 30% to 40%
Excretion: Mainly in urine, others in feces

Contraindications
• Hypersensitivity to the drug.
• Safe during pregnancy but should not be
taken by lactating mothers.
 Adverse Effects
CNS: headache, dizziness, insomnia, confusion,
psychotic symptoms with some preparations,
peripheral neuropathy
CV: bradycardia, arrythmia
GI: elevated liver enzymes, nausea, vomiting,
diarrhea
Hematologic: agranulocytosis, aplastic anemia,
neutropenia, thrombocytopenia
Hepatic: jaundice
Musculoskeletal: muscle pain
Skin: acnelike rash, urticaria
 Nursing management
• Assess pain, fluid & electrolyte balance and
nutritional status
• Evaluate client’s normal state of mind because
psychiatric effects have been reported
• Assess for the presence of liver and renal
damage
• Instruct client to avoid OTC medications
• Instruct the client regarding dietary
restrictions
• Instruct client on the critical nature of
eliminating the cause when possible and
modifying diet as needed.
 Sample drugs
• Cimetidine (Tagamet)-first
histamine-2 antagonist
• Ranitidine (Zantac)
• Famotidine (Pepcid)
• Nizatidine (Axid)