Protonix Pantoprazole

DRUG CARD Trade Name/Generic: PROTONIX/Pantoprazole pg 805 Classification: proton pump inhibitor Indications: GERD/severe erosive esophagitis/pathologic hypersecretory conditions (ie Zollinger-Ellison Syn) , maintenance Unlabeled uses: NSAID ulcer prophylaxis, H. pylori-assoc ulcer, gastric/duodenal ulcer Action: blocks final step of acid production, inhibits H+/K+ ATPase in gastric parietal cell suppressing gastric secretion. Therapeutic Effects: Absence of epigastric pain, fullness, pain. Absorption: GI tract Distribution: GI tract Protein binding: 97% Metabolism: Excretion: Urine as metabolites, in feces. **Elimination rate ↓ in geriatric pts** Half-life: 1.5 hr Contraindications: Hypersensitivity Precautions: Cat C pregnancy, children, breast feeding Adverse Reactions/Side Effects: CNS: headache, insomnia EENT: RESP: CV: MS: GI: abd pain, flatulence, diarrhea GU: DERM: rash ENDO: F&E: --Fluid and Electrolytes HEMAT: Hypergylcemia LOCAL: IV site OPTHALMIC: NEURO: MISC.: Interactions: ↑ pantoprazole serum levels w/ meds: diazepam, flurazepam, triazolam, clarithromycin, phenytoin ↓ absorption w/meds: calcium carbonate, vit B12, sucralfate ↑ blding w/ Warfarin Route & Dosage: GERD- Adult - PO 40mg/d X 8 wks (may repeat dose) Erosive esophagitis – Adult - IV 40 mg/d X 7-10; PO 40 mg/d X 8 wks-may repeat PO dose Ulcer – Adult – PO 40 mg/d H. pylori – Adult – 40 mg bid ; can use w/ other products Pathologic hypersecretory – Adult – IV 80 mg q12h; max40 mg/d Availability: Delayed release tabs 20mg, 40 mg; powder for inj; freeze-dried 40mg/vial

Onset:

Peak: 2.4 hr

Nursing implications: Assessment:

Hepatic – AST, ALT, alk phos during tx GI – bowel sounds q 8 hrs; abd swelling, pain, anorexia

Duration: >24hr

DRUG CARD Lab considerations: Hepatic-AST,ALT, alk phos during tx

Potential Nursing Diagnoses: Risk for Nutrition imbalance R/T decreased peristalsis, increased HCL acid production & post anesth 2nd to GERD

Implementation: PO- swallow del rel tab whole (do NOT crush, break, chew), Take 24 hrs apart, with or without food IV – Reconstitute w/ 10 ml 0.9% NaCl, dilute further w/ 80 ml LR, D5, 0.9% NaCl (0.8mg/ml), Give over 15 min (< 6 mg/min), IV push over 2 min

Patient/Family Teaching: Report severe diarrhea; if pt diabetic may cause hyperglycemia; avoid hazardous activities as dizziness may occur; avoid salicylates, iubprofin, ETOH- may cause GI irritation; do not breastfeed, in planning to become pregnant notify prescriber.

Evaluations: : Absence of epigastric pain, fullness, pain.

PROTONIX/ pantoprazole _______________________________________________ Drug