Rani

Drug Study Generic Name: Ranitidine hydrochloride Trade Name: Zantac Dosage: Adults Active duodenal ulcer: 150 mg bid PO for 4–8 wk. Alternatively, 300 mg PO once daily at bedtime or 50 mg IM or IV every 6–8 hr or by intermittent IV infusion, diluted to 100 mL and infused over 15–20 min. Do not exceed 400 mg/day. Maintenance therapy, duodenal ulcer: 150 mg PO at bedtime. Maintenance therapy, gastric ulcer: 150 mg PO at bedtime. Active gastric ulcer: 150 mg bid PO or 50 mg IM or IV every 6–8 hr. Pathologic hypersecretory syndrome: 150 mg bid PO. Individualize the dose with patient’s response. Do not exceed 6 g/day. GERD, esophagitis, benign gastric ulcer: 150 mg bid PO. Treatment of heartburn, acid indigestion: 75 mg PO as needed.

Classification Pharmacologic Class: Histamine-2 (H2) antagonist Therapeutic Class: Gastric acid secretion inhibitor Pregnancy Category B

Availability: Tablets—75, 150, 300 mg; capsules—150, 300 mg effervescent tablets and granules— 25, 150 mg syrup—15 mg/mL; injection— 1, 25 mg/mL

Mechanism of Action Competitively inhibits the action of histamine at the H2 receptors of the parietal cells of the stomach, inhibiting basal gastric acid secretion and gastric acid secretion that is stimulated by food, insulin, histamine, cholinergic agonists, gastrin, and pentagastrin.

Indication General Indications - Short-term treatment of active duodenal ulcer - Maintenance therapy for duodenal ulcer at reduced dosage - Short-term treatment and maintenance Pharmacokinetics therapy of active, benign gastric ulcer Route Onset Peak Durati - Short-term on treatment of GERD Oral Varies 1-3 hr 8-12 hr - Pathologic IM Rapid 15 min 8-12 hypersecretory hr conditions (eg, Iv Imme 5-10 8-12 Zollinger-Ellison diate min hr syndrome) (adults only) - Treatment of Metabolism: Hepatic; erosive esophagitis T1/2: 2-3 hr Distribution: Crosses - Treatment of heartburn, acid placenta, enters breast indigestion, milk sour stomach Excretion: Urine

Contraindication Contraindicated - allergy to ranitidine, lactation. . Precaution - impaired renal or hepatic function - pregnancy

Source: Karch, Amy:2012 Lippincott's Nursing Drug Guide, pp. 1035-1037

Source: Karch, Amy:2012 Lippincott's Nursing Drug Guide, pp. 1035-1037

Drug-drug Interactions: - Increased effects of warfarin, TCAs.

Adverse Reaction CNS: Headache, malaise, dizziness, somnolence, insomnia, vertigo CV: Tachycardia, bradycardia, PVCs (rapid IV administration) Dermatologic: Rash, alopecia GI: Constipation, diarrhea, nausea, vomiting, abdominal pain, hepatitis, increased ALT levels GU: Gynecomastia, impotence or decreased libido Hematologic: Leukopenia, granulocytopenia, thrombocytopeni a, pancytopenia Local: Pain at IM site, local burning or itching at IV site Other: Arthralgias

Nursing Responsibilities Before: - Observe 15 rights in drug administration. - Assess history: allergy to ranitidine, impaired renal or hepatic function, lactation, pregnancy. - Assess for patient's affect and orientation; liver evaluation, CBC, renal function test.

Source: Karch, Amy:2012 Lippincott's Nursing Drug Guide, pp. 1035-1037

Source: Karch, Amy:2012 Lippincott's Nursing Drug Guide, pp. 1035-1037

Routes of Administration: Oral Intravenous Intramuscular Source: Karch, Amy:2012 Lippincott's Nursing Drug Guide, pp. 1035-1037

Source: Karch, Amy:2012 Lippincott's Nursing Drug Guide, pp. 1035-1037

Source: Karch, Amy:2012 Lippincott's Nursing Drug Guide, pp. 1035-1037

During: - Administer oral drug with meals and at bedtime. - Decrease doses in renal and liver failure. - Administer IM dose undiluted, deep into large muscle group. After: - instruct patient to take drug with meals at bedtime. - instruct patient of the side effects. - instruct to report sore throat, fever, unusual bruising or bleeding, tarry stools, confusion, hallucinations, dizziness, severe headache, muscle or joint pain. - Document that the drug has been given.