Ranitidine

Histamine H2-antagonist and inhibits actions

of histamine mediated by H2-receptors such
as gastric acid secretion and pepsin output
Uses : peptic ulcer disease, including stress
ulceration
For the management of patients at risk from
stress ulceration, parenteral therapy may be
given as a slow intravenous injection of a 50-mg
priming dose followed by a continuous
intravenous infusion of 125 to 250 micrograms/kg
per hour. Oral doses of 150 mg twice daily may be
given once oral feeding is resumed.

 Action Reversibly and competitively blocks histamine at H2 receptors, particularly those in

gastric parietal cells, leading to inhibition of gastric acid secretion.
Indications Treatment and maintenance of duodenal ulcer; management of
gastroesophageal reflux disease (GERD; including erosive or ulcerative disease); short-term
treatment of benign gastric ulcer; treatment of pathologic hypersecretory conditions
(Zollinger-Ellison). Unlabeled use(s): Prevention of upper GI bleeding; treatment of
aspiration pneumonia; stress ulcer; and gastric NSAID damage. Used as a part of a multi-drug
regimen to eradicate Helicobacter pylori in the treatment of peptic ulcer; protection against
aspiration of acid during anesthesia; prevention of gastro duodenal mucosal damage that may
be associated with long-term NSAIDS; to control acute upper GI bleeding; prevention of
stress ulcers.
Contraindications Hypersensitivity to ranitidine or other H2 antagonists
Route/Dosage
Duodenal Ulcer (Active) ADULTS: PO 150 mg bid or 300 mg at bedtime. Maintenance: 150
mg at bedtime. IM/IV/Intermittent IV 50 mg q 6 to 8 hr.
Acute Benign Gastric Ulcer and GERD ADULTS: PO 150 mg bid. IM/IV/Intermittent IV 50
mg q 6 to 8 hr.
Interactions Diazepam: Pharmacologic effects may be decreased due to decreased GI
absorption by ranitidine. Staggering administration times may avoid this reaction. Ethanol:
May increase plasma ethanol levels. Glipizide: Possible increased hypoglycemia effect.
Ketoconazole: May decrease effects of ketoconazole. Lidocaine: May cause increased
lidocaine levels. Warfarin: Ranitidine may interfere with warfarin clearance.
Hypoprothrombinemic effects may increase; may need adjustment.
Adverse Reactions CV: Cardiac arrhythmias; bradycardia. CNS: Headache; somnolence;
fatigue; dizziness; hallucinations; depression; insomnia. DERM: Alopecia; rash; erythema
multiforme. GI: Nausea; vomiting; abdominal discomfort; diarrhea; constipation; pancreatitis.
HEMA: Agranulocytosis; autoimmune hemolytic or aplastic anemia; thrombocytopenia,
granulocytopenia. HEPA: Cholestatic or hepatocellular effects. OTHER: Hypersensitivity
reactions.

Ibuprofen
Action Decreases inflammation, pain, and fever, probably through inhibition of
cyclooxygenase activity and prostaglandin synthesis.
Indications Relief of symptoms of rheumatoid arthritis, osteoarthritis, mild-tomoderate pain, primary dysmenorrhea, reduction of fever.
Contraindications Hypersensitivity to aspirin, iodides, or any other NSAID
Dosage Mild-to-Moderate Pain ADULTS: PO 400 mg q 4 to 6 hr prn.
Interactions Beta-blockers: Antihypertensive effect may be decreased. Digoxin:
Ibuprofen may increase digoxin serum levels. Lithium: May increase lithium levels.
Loop diuretics: Diuretic effects may be decreased. Methotrexate: May increase
methotrexate levels. Warfarin: May increase risk of gastric erosion and bleeding.
Adverse Reactions CV: Peripheral edema; water retention; worsening or
precipitation of CHF. CNS: Dizziness; lightheadedness; drowsiness; vertigo;
headaches; aseptic meningitis. EENT: Visual disturbances; photophobia; tinnitus. GI:
Gastric distress; occult blood loss; diarrhea; vomiting; nausea; heartburn;
dyspepsia; anorexia; constipation; abdominal distress/cramps/pain; flatulence;
indigestion; GI tract fullness. GU: Menometrorrhagia; hematuria; cystitis; acute
renal insufficiency; interstitial nephritis; hyperkalemia; hyponatremia; renal
papillary necrosis. DERM: Rash; pruritus; erythema. OTHER: Muscle cramps.
Precautions Pregnancy: Pregnancy category undetermined. Lactation:
Undetermined. Children: Safety and efficacy not established. Elderly: Increased risk
of adverse reactions. GI effects: Serious GI toxicity (eg, bleeding, ulceration,
perforation) can occur at any time, with or without warning symptoms. Renal
effects: Increased risk of dysfunction in patients with preexisting renal disease