Patients Name: Age: Sex: Admitting Diagnosis: Attending Physician: Admission Date/Time: Temp: Chief Complaint: Doctors Order:

Date/Time Ordered: Generic Name

Pao, Elsa 32 years old Female Acute gastritis Dr. Hilarion Heramil, MD February 3, 2011 8:20am 37.1C Epigastric pain AlMgOH 10cc TID 1 pc x 6 and February 3, 2011 8:25am Aluminum Hydroxide, Magnesium Hydroxide Al(OH)3 225 mg, Mg(OH)2 200 mg

Brand Name Functional Classification Chemical Classification

Maalox (suspension) Gastrointestinal Antacids, Antireflux Agents & Antiulcerants

Indication Contraindication

Symptomatic relief of hyperacidity. Severe debilitation, kidney failure.

Mode of Action

Maalox is a balanced mixture of 2 antacids: Aluminum hydroxide is a slow-acting antacid and magnesium hydroxide is fast acting. The 2 are frequently combined in antacid mixtures. Aluminum hydroxide on its own is astringent and may cause constipation. This effect is balanced by the effect of magnesium hydroxide, which, in common with other magnesium salts, may cause diarrhea. Aluminum Hydroxide dissolves in acidic gastric secretions, releasing anions that partially neutralize gastric hydrochloric acid. Also elevates gastric pH, inhibiting the action of pepsin (an effect important in

peptic ulcer disease). Suspension: Ideal Dosage Preparation and Supply Form 2-4 teaspoons (10-20 mL) 4 times a day taken 20 min to 1 hr after meals and at bedtime or as directed by the physician. Maalox Plus: Max: 16 tsp per 24-hr period. Adverse Effect Gastrointestinal side effects are uncommon. Occasionally, high doses of antacids may cause diarrhea or constipation. Drug Interaction

Aluminium hydroxide may form complexes with certain drugs eg, tetracyclines, digoxin and vitamins, resulting in decreased absorption. This should be borne in mind when concomitant administration is considered. Concomitant use with quinidines may increase the serum levels of quinidine and lead to quinidine overdosage. Aluminum-containing antacids may prevent the proper absorption of H2-antagonists, atenolol, chloroquine, cyclines, diflunisal, digoxin, diphosphonates, ethambutol, fluoroquinolones, sodium fluorine, glucocorticoids, indomethacin, isoniazid, kayexalate, ketoconazole, lincosamides, metoprolol, neuroleptics, phenothiazines, penicillamine, propranolol, iron salts. Staggering the administration times of the interacting drug and the antacid by at least 2 hrs (4 hrs for the fluoroquinolones) will often help avoid undesirable drug interactions.

AlMgOH (Maalox) was given to the patient since it Rationale for Giving the Medication is an antacid and antiulcerant that can neutralize the acidity of the stomach. This acidity causes the inflammation by destroying the gastric mucosal wall and causes pain especially when there are foods in the stomach and hydrochloric acid release increases. In addition, neutralizing the acidity of the stomach prevents perforation of its wall. A. Assessment Nursing Responsibilities

1.

Assess for allergies and

preexisting conditions that may restrict the use of antacids, such as: Fluid imbalances, Renal disease, Congestive Heart Failure, Pregnancy, and GI obstruction

2.

Assess for GI bleeding to

determine whether perforation is already present and plan for appropriate interventions. 3. Interventions

1. Observe 10 rights in drug administration to

avoid medication errors.

2. Monitor and record pain scales to serve as

baseline data and to determine the effectiveness of the drug. 3. Give drug 20 min- 1 hour after meal to counteract the hydrochloric acid production by neutralizing the acidity. 4. Administer with at least 8 ounces of water to enhance absorption 5. Monitor stool consistency to prevent diarrhea and constipation.

6. Use with caution with other medications

due to the many drug interactions.

7. Monitor for therapeutic response notify

heath NOD if symptoms are not relieved.

C. Health Teachings

1.

Instruct patient to avoid caffeine,

alcohol, harsh spices, and black pepper because it may aggravate the underlying GI condition.

2.

Instruct patient to increase fiber

and fluid intake and regular physical activity to help ease constipation. 3. Instruct patient to eat banana if diarrhea occurred.