Omeprazole (brand names: Prilosec, Zegerid, Omepral, Omez)
Lansoprazole (brand names: Prevacid, Zoton, Inhibitol)
Dexlansoprazole (brand name: Kapidex, Dexilant)
Esomeprazole (brand names: Nexium, Esotrex)
Pantoprazole (brand names: Protonix, Somac, Pantozol, Zentro)
Think of a pump in your stomach just churning out the acid - 'Zole' is the nice guy who shuts off the pump.
'Zole' is very friendly (well-tolerated by most clients) but can cause vitamin B-12 deficiency if he stays around
too long (with long-term use).
There are many causes of anemia and the antianemic prescribed will be based upon the cause.
With iron deficiency anemia, iron supplements are commonly prescribed. Beware though - Iron is 'heavy' stuff
and shouldn't be taken 'lightly'!
· Iron can cause teeth staining (liquid form). Teach clients to dilute liquid iron with water or juice, drink with a
straw, and rinse mouth after swallowing.
· Iron can cause staining of skin and other tissues with IM injections. If IM route must be used, give IM doses
deep IM using Z track technique.
· Iron also has several drug administration interactions- of antacids or tetracycline's reduces absorption of
iron. Separate use by at least 2 hr.
· Vitamin C increases absorption, but also increases incidence of GI complications. Avoid vitamin C intake
when taking medication.
· Instruct clients to take iron on an empty stomach such as 1 hr before meals to maximize absorption.
Stomach acid increases absorption. However, iron can cause GI distress(nausea, constipation, heartburn) If
intolerable, iron can be administered with food to increase compliance with therapy but this does reduce
· Instruct clients to space doses at approximately equal intervals throughout day to most efficiently increase
red blood cell production.
· Inform clients to anticipate a harmless dark green or black color of stool.
· Instruct clients to increase water and fiber intake (unless contraindicated), and to maintain an exercise
program to counter the constipation effects.
· Encourage concurrent intake of appropriate quantities of foods high in iron (liver, egg yolks, muscle meats,
H eparin sodium prevents thrombin from converting fibrinogen to fibrin. It is administered IV or SQ.
E noxaparin (Lovenox) is a low-molecular weight heparin. It has the same action as heparin, but has a longer
half-life. It is administered via subcutaneous injection.
P rotamine sulfate is the antidote for heparin.
A dminister heparin when there is the likelihood of clot formation, such as with myocardial infarction or deepvein
R isk for bleeding is the major side effect that clients should be educated about. Clients should be educated to
monitor for bleeding, including bleeding gums, bruises, hematuria, and petechiae.
I nstruct clients to avoid corticosteroid use, salicylates, NSAIDs, green leafy vegetables, and foods high in
N ormal activated partial thromboplastin time (aPTT) is 20 to 36 seconds, but to maintain a therapeutic level
of anticoagulation while on heparin, the aPTT should be 1.5 to 2 times the normal value (60 to 80 seconds).
• Allergic reaction symptoms, including fast heart beat, itching or hives, swelling in the face or hands, swelling or tingling in the mouth or throat, chest tightness, and wheezing
• Unexplained fever, chills, or sore throat. Severe nausea, vomiting, or diarrhea