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pantoprazole
(pan toe' pray zol)
Pantoloc (CAN), Protonix, Protonix IV
Pregnancy Category B
Drug classes
Antisecretory agent
Proton pump inhibitor
Therapeutic actions
Gastric acid-pump inhibitor: Suppresses gastric acid secretion by specific inhibition of the hydrogen-potassium
ATPase enzyme system at the secretory surface of the gastric parietal cells; blocks the final step of acid
production.
Indications
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Oral: Short-term (< 8 wk) and long-term treatment of GERD
IV: Short-term (7–10 days) treatment of GERD in patients unable to continue oral therapy
Treatment of pathological hypersecretory conditions associated with Zollinger-Ellison syndrome and
other neoplastic conditions
Unlabeled uses: Treatment of peptic ulcer
Contraindications and cautions
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Contraindicated with hypersensitivity to any proton pump inhibitor or any drug components.
Use cautiously with pregnancy, lactation.
Pharmacokinetics
Route
Oral
IV
Onset
1 hr
Rapid
Peak
3–5 hr
3–5 hr
Metabolism: Hepatic; T1/2: 1.5 hr
Distribution: Crosses placenta; may enter breast milk
Excretion: Urine and bile
IV facts
Preparation: Reconstitute with 10 mL 0.9% sodium chloride; may then be further diluted with 100 mL 5%
dextrose injection, 0.9% sodium chloride injection or lactated Ringer's, final concentration 0.4 mg/mL;
reconstituted solution can be stored 2 hr, dilution up to 12 hr at room temperature.
Infusion: Infuse over at least 15 min using in-line filter.
Incompatibilities: Do not mix with or administer through the same line as other IV solutions.
Adverse effects
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CNS: Headache, dizziness, asthenia, vertigo, insomnia, apathy, anxiety, paresthesias, dream
abnormalities
Dermatologic: Rash, inflammation, urticaria, pruritus, alopecia, dry skin
GI: Diarrhea, abdominal pain, nausea, vomiting, constipation, dry mouth, tongue atrophy
Respiratory: URI symptoms, cough, epistaxis
Other: Cancer in preclinical studies, back pain, fever
Interactions
Drug-drug
 Fewer drug interactions reported than with other proton pump inhibitors
Nursing considerations
Assessment
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History: Hypersensitivity to any proton pump inhibitor or any drug components; pregnancy; lactation
Physical: Skin lesions; T; reflexes, affect; urinary output, abdominal examination; respiratory
auscultation
Interventions
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Administer once or twice a day. Caution patient to swallow tablets whole; not to cut, chew, or crush
them.
WARNING: Arrange for further evaluation of patient after 4 wk of therapy for gastroreflux disorders.
Symptomatic improvement does not rule out gastric cancer; gastric cancer did occur in preclinical
studies.
Maintain supportive treatment as appropriate for underlying problem.
Switch patients on IV therapy to oral dosage as soon as possible.
Provide additional comfort measures to alleviate discomfort from GI effects and headache.
Teaching points
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Take the drug once or twice a day. Swallow the tablets whole—do not chew, cut, or crush them.
Arrange to have regular medical follow-up care while you are using this drug.
Maintain all of the usual activities and restrictions that apply to your condition. If this becomes difficult,
consult with your nurse or physician.
You may experience these side effects: Dizziness (avoid driving a car or performing hazardous tasks);
headache (consult with your nurse if these become bothersome, medications may be available to help);
nausea, vomiting, diarrhea (proper nutrition is important, consult with your dietitian to maintain
nutrition; ensure ready access to bathroom facilities); symptoms of URI, cough (it may help to know that
this is a drug effect, do not self-medicate, consult with your nurse or physician if this becomes
uncomfortable).
Report severe headache, worsening of symptoms, fever, chills, blurred vision, periorbital pain.
Adverse effects in Italic are most common; those in Bold are life-threatening.