A patient who is taking NSAIDs to treat arthritis asks the nurse why misoprostol has also been prescribed. Which explanation by the nurse is accurate?
a. NSAIDs often cause GI irritation that can result in peptic ulcers.
b. NSAIDs promote the production of prostaglandins and reduce the incidence of gastric irritation.
c. Antiulcer medications eradicate the presence of bacteria in the stomach that cause ulcers.
d. Drug interactions are prevented when antiulcer medications are used in combination with NSAIDs.
ANS: A
Misoprostol, a GI prostaglandin, is used to prevent and treat gastric ulcers caused by NSAIDs. Prostaglandin inhibition is effective in reducing pain and inflammation, especially in arthritis, but makes the patient more predisposed to peptic ulcers. Prostaglandins are normally present in the GI tract to inhibit gastric acid and pepsin secretion to protect the stomach and duodenal lining against ulceration. NSAIDs inhibit prostaglandin production. Bismuth subsalicylate, metronidazole, and tetracycline combination (Helidac), as well as lansoprazole, clarithromycin, and amoxicillin combination (Prevpac), are used to treat infections caused by Helicobacter pylori. Drug interactions are not prevented by the presence of antiulcer medications.
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