Nizatidine Antacids

HISTAMINE H2 ANTAGONISTS. The nurse administers ranitidine and oral cimetidine before or with meals and at bedtime Nizatidine and famotidine are given at bedtime or, if twice-a-day dosing is prescribed, in the morning and at bedtime. These drugp are usually given concurrently with an antacid to relieve the pain. In certain situations or disorders, cimetidine and ranitidine may also be given by intermittent IV infusion or direct IV injection. 

Antacid/alginic acid (Gaviscon) 2 tablets or 1 5 mL after meals and at bedtime AND/OR C. Patient-directed therapy Over-the-counter H2RAs (each taken up to twice daily) - Cimetidine 200 mg - Lamotidine 1 0 mg - Nizatidine 75 mg - Ranitidine 75 mg OR Over-the-counter PPI (taken once daily) - Omeprazole 20 mg agent. 

Intermittent, mild heartburn Lifestyle modifications plus patient-directed therapy Antacids Maalox or Mylanta 30 mL as needed or after meals and at bedtime Gaviscon 2 tabs after meals and at bedtime Calcium carbonate 500 mg, 2-4 tablets as needed and/or Nonprescription 11 receptor antagonists (taken up to twice daily) Cimetidine 200 mg Famotidine 10 mg Nizatidine 75 mg Ranitidine 75 mg or... 

Drugs that may affect aspirin include activated charcoal, ammonium chloride, ascorbic acid or methionine, antacids and urinary alkalinizers, carbonic anhydrase inhibitors, corticosteroids, and nizatidine. Drugs that may be affected by aspirin include alcohol, ACE inhibitors, anticoagulants (oral), beta-adrenergic blockers, heparin, loop diuretics, methotrexate, nitroglycerin, NSAIDs, probenecid and sulfinpyrazone, spironolactone, sulfonylureas and exogenous insulin, and valproic acid. 

Deravirdine (Rescnptor) [Antiretroviral/NNRTI] Uses HIV Infxn Action Nonnucleoside RT inhibitor Dose 400 mg PO tid Caution [C, ] CDC recommends HIV-infected mothers not to breast-feed (transmission risk) w/ renal/hepatic impair Contra Use w/ drugs dependent on CYP3A for clearance (Table VI-8) Disp Tabs SE Fat redistribution, immune reconstitution synd, HA, fatigue, rash, T transaminases, N/V/D Interactions T Effects W/ fluoxetine T effects OF benzodiazepines, cisapride, clarithromycin, dapsone, ergotamine, indinavir, lovastatin, midazolam, nifedipine, quinidine, ritonavir, simvastatin, terfena-dine, triazolam, warfarin effects W/ antacids, barbiturates, carbamazepine, cimetidine, famotidine, lansoprazole, nizatidine, phenobarbital, phenytoin, ranitidine, rifabutin, rifampin effects OF didanosine EMS Use of benzodiazepines and CCBs should be avoided may cause a widespread rash located on upper body and arms OD May cause an extension of nl SEs symptomatic and supportive Deferasirox (Exjade) [Iron Chelator] Uses Chronic iron overload d/t transfusion in pts >2 y Action Oral iron chelator Dose Initial 20 mg/kg... 

Histamine H2-receptor antagonists are well absorbed orally, although concurrent antacid therapy may reduce bioavailability by up to 30%. They are widely distributed in the body, crossing the blood-brain barrier and the placenta. Cimetidine, ranitidine and famotidine are extensively metabolised in the liver, and about one-third excreted unchanged in urine, while only one-third of nizatidine is metabolised (Table 11.1). Elimination half-life is increased up to tenfold in renal failure, and doses must be adjusted. 

The absorption of cimetidine, famotidine, nizatidine, and ranitidine may possibiy be reduced to some extent by antacids, but it seems doubtful if this significantly reduces their effects. Separating the dosages by 1 to 2 hours minimises any interaction. Roxa-tidine absorption appears not to be affected by antacids. Cimetidine appears not to interfere with the effectiveness of Gaviscon (sodium alginate compound). 

---