Contraindications: Gastric Upset – NSAIDs (Nursing)

00:00 Now the third one is gastric impact and I know you're gonna nail that because we've walked through that a couple times.

00:06 So write yourself some quick notes and enjoy what you've already learned before we go on.

00:16 Let's see how you did. Okay, so gastric impact of Cox-1, you're gonna have these inhibitors.

00:23 You're gonna end up with some stomach upset, intestinal bleeding, and ulcers.

00:27 Those are the big three but look, they're all attached to each other because it's coming from irritation of that lining.

00:35 Lack of protection for your stomach lining.

00:38 That's why their stomach feels kind of upset.

00:40 Now, severe would be an ulcer or at least to intestinal bleeding.

00:45 Those are a lot more intense but nobody likes an upset stomach.

00:49 Again, all three line up with -- hey, with Cox-1 inhibitors, I'm gonna have less of this available so that's why you're gonna have these three effects.

01:00 The stomach upset, a risk for bleeding, and ulcers.

01:04 So how do you minimize that because nobody wants to experience those or have an upset stomach? Well, sometimes taking your NSAIDs with a full meal, that will also help you.

01:16 Now I know we say up there with an antacid.

01:18 You have to be really careful with that and you wanna talk to your health care provider before you would use that strategy. Why? An antacid is over-the-counter.

01:28 Yeah, it is but an antacid will change the pH of your stomach, the gastric pH of your stomach, so that will also impact the absorption of the NSAID.

01:40 So you wanna be very clear, have a conversation with your health care provider and say, "Hey, I'm having some gastric upset." Now, you can take an NSAID with a full meal all on your own but before I would take any oral medication with an antacid, I would wanna talk with my health care provider and talk about what impact will this actually have on this particular NSAID.

02:02 Because usually, it makes them -- when you mess with the pH, it makes a drug a little bit less effective.

02:07 Now that's -- if that's helpful to you like you're weighing out the risks and the benefits with your health care provider, you can come up with the best solution for you.

02:16 Not for your neighbor, not for a friend, but the best care solution for you.

02:21 So that advice that the health care provider gives is simply for that patient in that setting.

02:28 Now, we've got some fancier things, right? We're just talking about antacids and food.

02:33 That's something that everybody has access to but there's also the drugs that you'll see on your screen there.

02:38 Misoprostol, that's cytotec. That can be used to help reduce stomach irritation with NSAIDs.

02:44 Now prilosec, these are gonna start to look familiar. Omeprazole, you've got Nexium.

02:50 These are gonna look like proton pump inhibitors, right? Those can help with dealing with less gastric acid.

02:57 Your stomach's upset because their lining isn't as protected as it used to be so one strategy is to use these drugs that we're talking about.

03:06 After the cytotec, we're using these drugs to directly minimize the gastric acid so that's how they can help deal with a gastric upset that comes with NSAIDs.

03:16 They're proton pump inhibitors. Now that is a powerful group of medication.

03:23 You see we've got them linked besides the misoprostol.

03:26 Proton pump inhibitors are the drugs that are the most effective at minimizing gastric acid.

03:33 So they're better than the H2 blockers. They're just the most effective group of drugs.

03:38 They're meant to be used for a short period of time so you'll -- that's another drug you'll in consultation with your health care provider.

03:46 Even though different dosages of these -- some of these drugs are available over the counter, you wanna make sure that the health care provider is aware of what you're taking.