Physiological Adaptation Q 88
A physician has diagnosed acute gastritis in a clinic patient. Which of the following medications would be contraindicated for this patient?
A. naproxen sodium (Naprosyn)
B. calcium carbonate (Tums)
C. clarithromycin (Biaxin)
D. furosemide (Lasix)
Correct Answer: A. naproxen sodium (Naprosyn)
Naproxen sodium is a nonsteroidal anti-inflammatory drug that can cause inflammation of the upper GI tract. For this reason, it is contraindicated in a patient with gastritis. COX-1 and COX-2 inhibition lead to decreased prostaglandin synthesis in the gastric mucosa. The prostaglandins maintain mucosal integrity, therefore decreased synthesis causes reduced protection to the tissue. However, studies indicate COX-1 has a more significant effect on the integrity of the mucosa; consequently, selective COX-2 inhibitors such as Celecoxib do not have as much of an effect on gastric tissue.
Option B: Calcium carbonate is used as an antacid for the relief of indigestion and is not contraindicated. Calcium carbonate is an inorganic salt primarily used in the management and treatment of low calcium conditions, GERD, CKD, and a variety of other indicated conditions. It is classified as a calcium supplement, antacid, and as a phosphate binder.
Option C: Clarithromycin is an antibacterial often used for the treatment of Helicobacter pylori in gastritis. Clarithromycin is in a class of medications called macrolide antibiotics. It works by stopping the growth of bacteria. Clarithromycin is used to treat certain bacterial infections, such as pneumonia (a lung infection), bronchitis (infection of the tubes leading to the lungs), and infections of the ears, sinuses, skin, and throat.
Option D: Furosemide is a loop diuretic and is contraindicated in a patient with gastritis. The Food and Drug Administration (FDA) has approved the use of furosemide in the treatment of conditions with volume overload and edema secondary to congestive heart failure exacerbation, liver failure, or renal failure including nephrotic syndrome.