A patient who has been taking ranitidine (Zantac) continues to have pain associated with peptic ulcer. A noninvasive breath test is negative. Which treatment does the nurse expect the provider to order for this patient?
a. Adding an over-the-counter antacid to the patient's drug regimen
b. A dual drug therapy regimen
c. Amoxicillin (Amoxil), clarithromycin (Biaxin), and omeprazole (Prilosec)
d. Lansoprazole (Prevacid) instead of ranitidine
ANS: D
This patient does not have H. pylori ulcer disease, so dual and triple drug therapy with antibiotics is not indicated. Patients who fail treatment with a histamine2 blocker should be changed to a proton pump inhibitor (PPI) such as lansoprazole. PPIs tend to inhibit gastric acid secretion up to 90% greater than the histamine antagonists.
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