Download cm/study group/Drugs/Zantac (ranitidine

ranitidine hydrochloride
(ra nye' te deen)
Alti-Ranitidine (CAN), Novo-Ranidine (CAN), Nu-Ranit (CAN), Zantac, Zantac
EFFERdose, Zantac GELdose, Zantac 75
Pregnancy Category B
Drug class
Histamine2 (H2) antagonist
Therapeutic actions
Competitively inhibits the action of histamine at the histamine2 (H2) receptors of the
parietal cells of the stomach, inhibiting basal gastric acid secretion and gastric acid
secretion that is stimulated by food, insulin, histamine, cholinergic agonists, gastrin, and
pentagastrin.
Indications
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Short-term treatment of active duodenal ulcer
Maintenance therapy for duodenal ulcer at reduced dosage
Short-term treatment of active, benign gastric ulcer
Short-term treatment of GERD
Pathologic hypersecretory conditions (eg, Zollinger-Ellison syndrome)
Treatment of erosive esophagitis
Treatment of heartburn, acid indigestion, sour stomach
Contraindications and cautions
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Contraindicated with allergy to ranitidine, lactation.
Use cautiously with impaired renal or hepatic function, pregnancy.
Pharmacokinetics
Route
Oral
IM
IV
Onset
Varies
Rapid
Immediate
Peak
1–3 hr
15 min
5–10 min
Duration
8–12 hr
8–12 hr
8–12 hr
Metabolism: Hepatic; T1/2: 2–3 hr
Distribution: Crosses placenta; enters breast milk
Excretion: Urine
Incompatibilities: Do not mix with amphotericin B
Adverse effects
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CNS: Headache, malaise, dizziness, somnolence, insomnia, vertigo
CV: Tachycardia, bradycardia, PVCs (rapid IV administration)
Dermatologic: Rash, alopecia
GI: Constipation, diarrhea, nausea, vomiting, abdominal pain, hepatitis,
increased ALT levels
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GU: Gynecomastia, impotence or decreased libido
Hematologic: Leukopenia, granulocytopenia, thrombocytopenia, pancytopenia
Local: Pain at IM site, local burning or itching at IV site
Other: Arthralgias
Interactions
Drug-drug
 Increased effects of warfarin, TCAs; monitor patient closely and adjust dosage as
needed
Nursing considerations
Assessment
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History: Allergy to ranitidine, impaired renal or hepatic function, lactation,
pregnancy
Physical: Skin lesions; orientation, affect; pulse, baseline ECG; liver evaluation,
abdominal examination, normal output; CBC, liver and renal function tests
Interventions
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Administer oral drug with meals and hs.
Decrease doses in renal and liver failure.
Provide concurrent antacid therapy to relieve pain.
Administer IM dose undiluted, deep into large muscle group.
Arrange for regular follow-up, including blood tests, to evaluate effects.
Teaching points
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Take drug with meals and at bedtime. Therapy may continue for 4–6 wk or
longer.
If you also are on an antacid, take it exactly as prescribed, being careful of the
times of administration.
Have regular medical follow-up care to evaluate your response.
You may experience these side effects: Constipation or diarrhea (request aid from
your health care provider); nausea, vomiting (take drug with meals); enlargement
of breasts, impotence or decreased libido (reversible); headache (adjust lights and
temperature and avoid noise).
Report sore throat, fever, unusual bruising or bleeding, tarry stools, confusion,
hallucinations, dizziness, severe headache, muscle or joint pain.
Adverse effects in Italic are most common; those in Bold are life-threatening.