Esomeprazole

dr.joan

Esomeprazole:
Trade names: Nexium

Class: Proton pump inhibitors, antinuclear agents

Pregnancy: (Category

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:
  • Diminished accumulation of acid in the gastric lumen with lessened gastroesophageal reflux
  • Healing of duodenal ulcers.

Uses:

• Treatment of GERD including:
  • Healing of erosive esophagitis
  • Maintenance of healing of erosive esophagitis
  • 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.