Esomeprazole
Trade names:
Nexium
Class: Proton pump inhibitors, antinuclear agents
Pregnancy:
(Category B)
Action:
§ Binds to an enzyme on gastric parietal cells in the presence of
acidic gastric pH, preventing the final transport of hydrogen ions into the
gastric lumen.
§ Therapeutic
Effects:
o Diminished accumulation of acid
in the gastric lumen with lessened gastroesophageal reflux o Healing of
duodenal ulcers.
Uses:
§ Treatment of GERD including:
o
Healing of erosive
esophagitis
o
Maintenance of healing of
erosive esophagitis o
Treatment of symptomatic GERD
§ In combination with amoxicillin and clarithromycin for the
eradication of Helicobacter pylori in patients with duodenal ulcer disease or a
history of duodenal ulcer disease. (Information on cucurrent use with
amoxicillin and clarithromycin can be found in Davis's Drug Guide for Nurses.
Dose:
Gastro-oesophageal reflux disease, 40 mg once
daily for 4 weeks, followed by a further
4 weeks if not fully healed or symptoms persist; maintenance 20 mg daily;
symptomatic
treatment in the absence of oesophagitis, 20 mg
daily for up to 4 weeks, followed by 20 mg daily when required
CHILD : not recommended Contraindications:
§ Hypersensitivity
§ Lactation (not recommended).
Side effects:
CNS: headache.
GI: abdominal pain, constipation,
diarrhea, dry mouth, flatulence, nausea.
Nursing
considerations:
§ NEXIUM should be taken at least one hour before meals.
§ For patients who have a nasogastric or gastric tube in place,
NEXIUM For Delayed-Release Oral Suspension can be administered as follows:
ü Add 15 mL of water to a catheter tipped syringe and then add the
contents of a 10 mg, 20 mg or 40 mg NEXIUM packet. It is important to only use
a catheter tipped syringe when administering NEXIUM through a nasogastric tube
or gastric tube.
ü Immediately shake the syringe and leave 2 to 3 minutes to
thicken.
ü Shake the syringe and inject through the nasogastric or gastric
tube, French size 6 or larger, into the stomach within 30 minutes.
ü Refill the syringe with 15 mL of water.
ü Shake and flush any remaining contents from the nasogastric or
gastric tube into the stomach.
§ NEXIUM For Delayed-Release Oral Suspension should be
administered as follows :
§ Empty the contents of a 10 mg, 20 mg or 40 mg packet into a
container containing 1 tablespoon (15 mL) of water .
§ Stir.
§ Leave 2 to 3 minutes to thicken .
§ Stir and drink within 30 minutes .
§ If any material remains after drinking, add more water, stir,
and drink immediately.
