pantoprazole

Panto IV

Pantoloc

Protonix

Protonix IV

Tecta

Indications

Action

Pharmacokinetics

Time/action profile (effect on acid secretion)

Contraindications/Precautions

Adverse Reactions/Side Effects

Central nervous system

• headache

Gastrointestinal

• pseudomembranous colitis (life-threatening)
• abdominal pain
• diarrhea
• eructation
• flatulence

Endocrinologic

• hyperglycemia

Fluid and Electrolyte

• hypomagnesemia (especially if treatment duration ≥3 mo)

Musculoskeletal

• bone fracture

Interactions

Drug-Drug interaction

Route/Dosage

GERD

Gastric Hypersecretory Conditions

Availability (generic available)

Nursing implications

Nursing assessment

• Assess patient routinely for epigastric or abdominal pain and for frank or occult blood in stool, emesis, or gastric aspirate.
• Lab Test Considerations: May cause abnormal liver function tests, including ↑ AST, ALT, alkaline phosphatase, and bilirubin.
  • May cause hypomagnesemia. Monitor serum magnesium prior to and periodically during therapy.

Potential Nursing Diagnoses

Implementation

• Do not confuse Protonix (pantoprazole) with Lotronex (alosetron) or protamine.
• Patients receiving pantoprazole IV should be converted to PO dosing as soon as possible.
• Monitor bowel function. Diarrhea, abdominal cramping, fever, and bloody stools should be reported to health care professional promptly as a sign of pseudomembranous colitis. May begin up to several weeks following cessation of therapy.
• Oral: May be administered with or without food. Do not break, crush, or chew tablets.
  • Antacids may be used concurrently.

• Intravenous Administration

• Intravenous: Reconstitute each vial with 10 mL of 0.9% NaCl. Reconstituted solution is stable for 6 hr at room temperature.
• Diluent: Administer undiluted.Concentration: 4 mg/mL.
• Rate: Administer over at least 2 min.
• Intermittent Infusion: Diluent: Dilute further with D5W, 0.9% NaCl, or LR.Concentration: 0.4–0.8 mg/mL. Diluted solution is stable for 24 hr at room temperature.
• Rate: Administer over 15 min at a rate of <3 mg/min.
• Y-Site Compatibility: allopurinol, alprostadil, amifostine, aminocaproic acid, amikacin, aminophylline, amphotericin B lipid complex, amphotericin B liposome, ampicillin, amipcillin/sulbactam, anidulafungin, argatroban, azithromycin, bleomycin, bumetanide, carboplatin, carmustine, ceftaroline, ceftriaxone, cyclophosphamide, cytarabine, docetaxel, doripenem, doxorubicin liposome, doxycycline, ertapenem, fluorouracil, foscarnet, fosphenytoin, ganciclovir, granisetron, imipenem/cilastatin, irinotecan., mesna, methyldopate, paclitaxel, penicillin G sodium, pentazocine, pentobarbital, phenobarbital, phentolamine, phenylephrine, potassium chloride, procainamide, rifampin, succinylcholine, sufentanyl, telavancin, teniposide, theophylline, ticarcillin/clavulanate, tigecycline, tirofiban, vasopressin, zidovudine, zoledronic acid
• Y-Site Incompatibility: alemtuzumab, alfentanil, amphotericin B colloidal, atropine, aztreonam, buprenorphine, butorphanol, calcium acetate, calcium chloride, cefepime, cefoperazone, cefotaxime, cefotetan, chloramphenicol, chlorpromazine, ciprofloxacin, cisatracurium, cisplatin, dacarbazine, dactinomycin, dantrolene, daptomycin, daunorubicin hydrochloride, dexamethasone, dexmedetomidine, dexrazoxane, diazepam, diltiazem, diphenhydramine, dobutamine, dolasetron, doxorubicin hydrochloride, droperidol, ephedrine, epirubicin, esmolol, etoposide, etoposide phosphate, famotidine, fenoldopam, fentanyl, fluconazole, fludarabine, furosemide, gemcitabine, glycopyrrolate, haloperidol, heparin, hydralazine, hydromorphone, hydroxyzine, idarubicin, ifosfamide, insulin/regular, ketorolac, labetalol, leucovorin, levofloxacin, levorphanol, lidocaine, linezolid, lorazepam, mechlorethamine, melphalan, meperidine, meropenem, methotrexate, methylprednisolone, metoprolol, metronidazole, midazolam, milrinone, mitomycin, mitoxantrone, morphine, mycophenolate, nalbuphine, naloxone, nesiritide, nicardipine, norepinephrine, ondansetron, palonosetron, pancuronium, pemetrexed, pentamidine, phenytoin, potassium acetate, potassium phosphates, prochlorperazine, promethazine, propranolol, quinupristin/dalfopristin, ranitidine, remifentanil, rocuronium, sodium acetate, sodium phosphates, streptozocin, thiotepa, tolazoline, topotecan, vecuronium, verapamil, vinblastine, vincristine, vinorelbine, voriconazole, solutions containing zinc

Patient/Family Teaching

• Instruct patient to take medication as directed for the full course of therapy, even if feeling better.
• Advise patient to avoid alcohol, products containing aspirin or NSAIDs, and foods that may cause an increase in GI irritation.
• Advise patient to report onset of black, tarry stools; diarrhea; or abdominal pain to health care professional promptly. Instruct patient to notify health care professional immediately if rash, diarrhea, abdominal cramping, fever, or bloody stools occur and not to treat with antidiarrheals without consulting health care professional.
• Instruct patient to notify health care professional of all Rx or OTC medications, vitamins, or herbal products being taken and consult health care professional before taking any new medications.
• Advise female patients to notify health care professional if pregnancy is planned or suspected or if breast feeding.

Evaluation/Desired Outcomes

• Decrease in abdominal pain heartburn, gastric irritation and bleeding in patients with GERD; may require up to 4 wk of therapy.
• Healing in patients with erosive esophagitis. Therapy is continued for up to 8 wk.