Histamine 2 Receptor Blockers

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Tarang Patel
DNP-NA,RN,CCRN, RPh
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Included In This Lesson

Study Tools For Histamine 2 Receptor Blockers

Common Medication Prefixes and Suffixes Cheatsheet (Cheatsheet)
140 Must Know Meds (Book)

Outline

Overview

  1. Histamine 2 Receptor Blockers
    1. Mechanism of action
      1. Blocks histamine from binding to histamine 2 receptors decreasing acid in the stomach
      2. Patho background
        1. Histamine 2 blockers are in the stomach
        2. Histamine binds to these blockers and stimulates acid prodcution
    2. Indications
      1. Stomach ulcers
      2. Peptic ulcer disease
      3. Intestinal ulcer
      4. Prevention of ulcers and acid reflux in hospitalized patients

Nursing Points

General

  1. Examples of Histamine 2 Receptor Blockers
    1. Cimetidine
      1. Able to cross the blood brain barrier
      2. Increased side effects
    2. Ranitidine
    3. Famotidine
    4. Nizatidine

Assessment

  1. Assess for side effects
    1. Diarrhea
    2. Constipation
    3. Headache
    4. Fatigue
    5. Nausea
    6. Dry mouth
    7. Decreased RBC, WBC, Platelets
    8. Confusion – Cimetidine only
    9. Gynecomastia

Therapeutic Management

  1. Monitor RBC’s WBC’s and platelets closely

Nursing Concepts

  1. Pharmacology
    1. Histamine 2 Receptor Blockers are often prescribed to hospitalized patients to prevent acid reflux and the formation of ulcers.

Patient Education

  1. Hospitalized patients should be educated on why this medication is being administered.

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Transcript

Histamine receptors blocker. So, in this video, we gonna talk about the histamine 2 receptor blocker. We already talked about the histamine 1, it’s time for histamine 2. So, where are these histamine 2 are located? Let’s talk about that first, then, we’ll be able to understand the mechanism of action of this class pretty easily. So, as we know, histamine 1 is inflammatory mediator receptors. So, it produce the inflammation and signs and symptoms. While these histamine 2 receptors are located in the stomach. And what the function is, when histamine comes and binds to this receptor, it produces this acid in our stomach.

So, as we know, this is the mechanism like when a histamine comes and binds to the histamine 2 receptors in stomach, it increases the secretions of acid in the stomach. That’s pretty much the work of the histamine when it binds to the histamine 2 receptor. Now, when we give this medication, histamine 2 receptor blocker, it blocks the effect of histamine on histamine 2 receptors, so it doesn’t let histamine produce, I mean it doesn’t let histamine to bind to histamine 2 receptor and it won’t be able to produce anymore acid in the stomach. So, that’s the mechanism of action of this histamine 2 receptor blocker medication that it decreases the, so basically, it decreases the secretion of acid in the stomach and intestine. ‘Cause there’s also some receptors in intestine and it prevents producing the acid in intestine either, intestine also.

So, what are the uses for this histamine 2 receptor? As we know, it prevents the production of acid so it can be used for stomach ulcers, peptic ulcer disease, could be used in intestinal ulcer, and also, it’s widely used as a prophylactic to prevent ulcer or acid reflux in hospital. Like a, when you have a patient in ICU, their body is under so much stress, they’re getting so many medications, they have a tube down to their throat, all the beeping, all the stress of ICU naturally produces more acid into their stomach. And when it produces more acid in their stomach and they’re lying in bed most of the, all the time, there’s a high chance they will have acid reflux and they can aspirate really badly. So, in order to prevent that acid reflux and aspiration of acids into their lungs, they usually put them on this prophylactic histamine 2 receptor blockers in ICU. So, that’s the one of the main use and widely used for that purpose as well.

What are the side effects? So, this medication causes many GI problems as well because it works on stomach and intestine. So, it definitely cause side effects on intestine. It can cause either diarrhea or constipation, either way, it can go. It can cause a bad headache, fatigue, nausea, it can cause a dry mouth, confusion. So, this particular side effects is caused by only one drug, Cimetidine. So, one drug, this is a drug in this class. And the reason this medication causes the confusion, it’s able to cross blood brain barrier. The rest of medication in this class will not be able to cross this blood brain barrier except the Cimetidine. So, if the patient is on Cimetidine, it can cause the confusion. The easier way to remember is like the first letter in this one is ‘C’ and it causes the CNS side effects. So, Cimetidine causes CNS side effects which is confusion. And it also can, these drugs also can decrease all blood cells types like the red blood cells, white blood cells and platelets. That’s why sometimes they need frequent lab drawn in able to make sure they don’t get any of the blood cells significantly lower that can cause more problems. And it can cause gynecomastia as well.

What are the examples of this medications? Ranitidine, Cimetidine, Famotidine and Nizatidine. It’s really easy to recognize these drugs as -tidine. TIDINE. TIDINE. And TIDINE. So, any drugs that ends with -tidine is a histamine 2 receptor blockers.

That’s really a short class. If you have any questions, any concerns about this video, just let us know.

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Pharmacology for Nursing (MedMaster)

The Pharmacology Course is a one-stop-shop for all things medication related! We’ll talk you through how to be successful in pharmacology and how to be safe when administering meds. We break down the most common and most important medication classes into easy-to-understand sections. We even walk you through how to conquer the often intimidating med math and drug calculations! When you finish this course you’ll be able to confidently and safely administer medications to your patients!

Course Lessons

0 - Pharmacology Course Introduction
Pharmacology Course Introduction
1 - NCLEX Must Knows
12 Points to Answering Pharmacology Questions
54 Common Medication Prefixes and Suffixes
Therapeutic Drug Levels (Digoxin, Lithium, Theophylline, Phenytoin)
Essential NCLEX Meds by Class
6 Rights of Medication Administration
Pharmacodynamics
Pharmacokinetics
The SOCK Method – Overview
The SOCK Method – S
The SOCK Method – O
The SOCK Method – C
The SOCK Method – K
2 - Math for Meds
Basics of Calculations
Dimensional Analysis Nursing (Dosage Calculations/Med Math)
Oral Medications
Injectable Medications
IV Infusions (Solutions)
Complex Calculations (Dosage Calculations/Med Math)
Interactive Pharmacology Practice
Interactive Practice Drip Calculations
Pediatric Dosage Calculations
3 - Disease Specific Medications
Disease Specific Medications
4 - Antianxiety Agents
Antianxiety Meds
Benzodiazepines
Alprazolam (Xanax) Nursing Considerations
Lorazepam (Ativan) Nursing Considerations
Midazolam (Versed) Nursing Considerations
Diazepam (Valium) Nursing Considerations
Buspirone (Buspar) Nursing Considerations
Antianxiety Meds
5 - Antiarrhythmics
ACLS (Advanced cardiac life support) Drugs
Amiodarone (Pacerone) Nursing Considerations
Adenosine (Adenocard) Nursing Considerations
Procainamide (Pronestyl) Nursing Considerations
6 - Anticoagulants & Thrombolytics
Anti-Platelet Aggregate
Clopidogrel (Plavix) Nursing Considerations
Coumarins
Warfarin (Coumadin) Nursing Considerations
Thrombin Inhibitors
Enoxaparin (Lovenox) Nursing Considerations
Heparin (Hep-Lock) Nursing Considerations
Thrombolytics
Alteplase (tPA, Activase) Nursing Considerations
Streptokinase (Streptase) Nursing Considerations
7 - Anticonvulsants
Anticonvulsants
Carbamazepine (Tegretol) Nursing Considerations
Divalproex (Depakote) Nursing Considerations
Gabapentin (Neurontin) Nursing Considerations
Lamotrigine (Lamictal) Nursing Considerations
Levetiracetam (Keppra) Nursing Considerations
Phenytoin (Dilantin) Nursing Considerations
8 - Antidepressants
Antidepressants
Bupropion (Wellbutrin) Nursing Considerations
MAOIs
Selegiline (Eldepyrl) Nursing Considerations
SSRIs
Escitalopram (Lexapro) Nursing Considerations
Fluoxetine (Prozac) Nursing Considerations
Paroxetine (Paxil) Nursing Considerations
Sertraline (Zoloft) Nursing Considerations
TCAs
Amitriptyline (Elavil) Nursing Considerations
9 - Antidiabetic Agents
Antidiabetic Agents
Glipizide (Glucotrol) Nursing Considerations
Metformin (Glucophage) Nursing Considerations
Insulin
Insulin – Rapid Acting (Novolog, Humalog) Nursing Considerations
Insulin – Short Acting (Regular) Nursing Considerations
Insulin – Intermediate Acting (NPH) Nursing Considerations
Insulin – Mixtures (70/30)
Insulin – Long Acting (Lantus) Nursing Considerations
10 - Antihistamines
Histamine 1 Receptor Blockers
Diphenhydramine (Benadryl) Nursing Considerations
Promethazine (Phenergan) Nursing Considerations
Histamine 2 Receptor Blockers
Cimetidine (Tagamet) Nursing Considerations
Famotidine (Pepcid) Nursing Considerations
Ranitidine (Zantac) Nursing Considerations
11 - Antihypertensives
Renin Angiotensin Aldosterone System
Sympatholytics (Alpha & Beta Blockers)
Atenolol (Tenormin) Nursing Considerations
Metoprolol (Toprol XL) Nursing Considerations
Propranolol (Inderal) Nursing Considerations
ACE (angiotensin-converting enzyme) Inhibitors
Captopril (Capoten) Nursing Considerations
Enalapril (Vasotec) Nursing Considerations
Lisinopril (Prinivil) Nursing Considerations
Angiotensin Receptor Blockers
Losartan (Cozaar) Nursing Considerations
Calcium Channel Blockers
Amlodipine (Norvasc) Nursing Considerations
Diltiazem (Cardizem) Nursing Considerations
Nifedipine (Procardia) Nursing Considerations
Verapamil (Calan) Nursing Considerations
Cardiac Glycosides
Digoxin (Lanoxin) Nursing Considerations
12 - Anti-Infectives
Anti-Infective – Aminoglycosides
Gentamicin (Garamycin) Nursing Considerations
Anti-Infective – Antifungals
Metronidazole (Flagyl) Nursing Considerations
Nystatin (Mycostatin) Nursing Considerations
Anti-Infective – Antitubercular
Isoniazid (Niazid) Nursing Considerations
Rifampin (Rifadin) Nursing Considerations
Anti-Infective – Antivirals
Acyclovir (Zovirax) Nursing Considerations
Anti-Infective – Carbapenems
Meropenem (Merrem) Nursing Considerations
Anti-Infective – Fluoroquinolones
Ciprofloxacin (Cipro) Nursing Considerations
Levofloxacin (Levaquin) Nursing Considerations
Anti-Infective – Glycopeptide
Vancomycin (Vancocin) Nursing Considerations
Anti-Infective – Lincosamide
Clindamycin (Cleocin) Nursing Considerations
Anti-Infective – Macrolides
Erythromycin (Erythrocin) Nursing Considerations
Azithromycin (Zithromax) Nursing Considerations
Anti-Infective – Penicillins and Cephalosporins
Amoxicillin (Amoxil) Nursing Considerations
Ampicillin (Omnipen) Nursing Considerations
Cefaclor (Ceclor) Nursing Considerations
Cefdinir (Omnicef) Nursing Considerations
Cephalexin (Keflex) Nursing Considerations
Anti-Infective – Sulfonamides
Trimethoprim-Sulfamethoxazole (Bactrim) Nursing Considerations
Anti-Infective – Tetracyclines
Tetracycline (Panmycin) Nursing Considerations
13 - Antipsychotics
Atypical Antipsychotics
Chlorpromazine (Thorazine) Nursing Considerations
Antipsychotics
Haloperidol (Haldol) Nursing Considerations
Quetiapine (Seroquel) Nursing Considerations
Olanzapine (Zyprexa) Nursing Considerations
14 - Autonomic Nervous System Meds
Autonomic Nervous System (ANS)
Methylphenidate (Concerta) Nursing Considerations
Sympathomimetics (Alpha (Clonodine) & Beta (Albuterol) Agonists)
Dobutamine (Dobutrex) Nursing Considerations
Dopamine (Inotropin) Nursing Considerations
Carbidopa-Levodopa (Sinemet) Nursing Considerations
Parasympathomimetics (Cholinergics) Nursing Considerations
Neostigmine (Prostigmin) Nursing Considerations
Parasympatholytics (Anticholinergics) Nursing Considerations
Atropine (Atropen) Nursing Considerations
Benztropine (Cogentin) Nursing Considerations
Diphenoxylate-Atropine (Lomotil) Nursing Considerations
15 - Bronchodilators & Respiratory Drugs
Guaifenesin (Mucinex) Nursing Considerations
Bronchodilators
Albuterol (Ventolin) Nursing Considerations
Montelukast (Singulair) Nursing Considerations
Salmeterol (Serevent) Nursing Considerations
16 - Diuretics
Diuretics (Loop, Potassium Sparing, Thiazide, Furosemide/Lasix)
Furosemide (Lasix) Nursing Considerations
Hydrochlorothiazide (Hydrodiuril) Nursing Considerations
Spironolactone (Aldactone) Nursing Considerations
Mannitol (Osmitrol) Nursing Considerations
17 - GI Meds
Bisacodyl (Dulcolax) Nursing Considerations
Bismuth Subsalicylate (Pepto-Bismol) Nursing Considerations
Lactulose (Generlac) Nursing Considerations
Loperamide (Imodium) Nursing Considerations
Metoclopramide (Reglan) Nursing Considerations
Ondansetron (Zofran) Nursing Considerations
Pancrelipase (Pancreaze) Nursing Considerations
Sucralfate (Carafate) Nursing Considerations
Proton Pump Inhibitors
Omeprazole (Prilosec) Nursing Considerations
Pantoprazole (Protonix) Nursing Considerations
18 - Hormone & Immune Related Drugs
Epoetin Alfa
Epoetin (Epogen) Nursing Considerations
Glucagon (GlucaGen) Nursing Considerations
Iodine Nursing Considerations
Levothyroxine (Synthroid)
Propylthiouracil (PTU) Nursing Considerations
Cyclosporine (Sandimmune) Nursing Considerations
19 - Lipid Lowering Drugs
HMG-CoA Reductase Inhibitors (Statins)
Atorvastatin (Lipitor) Nursing Considerations
20 - Mineral and Electrolyte Drugs
Magnesium Sulfate
Magnesium Sulfate in Pregnancy
Magnesium Sulfate (MgSO4) Nursing Considerations
Calcium Acetate (PhosLo) Nursing Considerations
Calcium Carbonate (Tums) Nursing Considerations
Ferrous Sulfate (Iron) Nursing Considerations
Alendronate (Fosamax) Nursing Considerations
21 - Mood Stabilizers
Mood Stabilizers
Lithium (Lithonate) Nursing Considerations
22 - Non-Opioid Analgesics
Acetaminophen (Tylenol) Nursing Considerations
Phenazopyridine (Pyridium) Nursing Considerations
NSAIDs
ASA (Aspirin) Nursing Considerations
Celecoxib (Celebrex) Nursing Considerations
Ibuprofen (Motrin) Nursing Considerations
Indomethacin (Indocin) Nursing Considerations
Ketorolac (Toradol) Nursing Considerations
Naproxen (Aleve) Nursing Considerations
23 - OB Meds
Tocolytics
Terbutaline (Brethine) Nursing Considerations
Uterine Stimulants (Oxytocin, Pitocin) Nursing Considerations
Meds for Postpartum Hemorrhage (PPH)
Methylergonovine (Methergine) Nursing Considerations
Oxytocin (Pitocin) Nursing Considerations
Prostaglandins in Pregnancy
Rh Immune Globulin in Pregnancy
Lung Surfactant for Newborns
Eye Prophylaxis for Newborn
Phytonadione (Vitamin K) for Newborn
Hepatitis B Vaccine for Newborns
24 - Opioid Analgesics
Opioids
Opioid Analgesics in Pregnancy
Butorphanol (Stadol) Nursing Considerations
Codeine (Paveral) Nursing Considerations
Fentanyl (Duragesic) Nursing Considerations
Hydrocodone-Acetaminophen (Vicodin, Lortab) Nursing Considerations
Hydromorphone (Dilaudid) Nursing Considerations
Meperidine (Demerol) Nursing Considerations
Methadone (Methadose) Nursing Considerations
Morphine (MS Contin) Nursing Considerations
Nalbuphine (Nubain) Nursing Considerations
Oxycodone (OxyContin) Nursing Considerations
25 - Sedatives / Hyponotics
Sedatives-Hypnotics
Barbiturates
Phenobarbital (Luminal) Nursing Considerations
Pentobarbital (Nembutal) Nursing Considerations
Anesthetic Agents
Propofol (Diprivan) Nursing Considerations
Lidocaine (Xylocaine) Nursing Considerations
26 - Steroids
Corticosteroids
Betamethasone and Dexamethasone in Pregnancy
Cortisone (Cortone) Nursing Considerations
Dexamethasone (Decadron) Nursing Considerations
Fluticasone (Flonase) Nursing Considerations
Methylprednisolone (Solu-Medrol) Nursing Considerations
27 - Vasodilators
Hydralazine
Hydralazine (Apresoline) Nursing Considerations
Nitro Compounds
Nitroglycerin (Nitrostat) Nursing Considerations
Nitroprusside (Nitropress) Nursing Considerations
28 - Vasopressors
Vasopressin
Epinephrine (EpiPen) Nursing Considerations
Norepinephrine (Levophed) Nursing Considerations
Vasopressin (Pitressin) Nursing Considerations
29 - Medications By Class
ACLS (Advanced cardiac life support) Drugs
Anti-Infective – Aminoglycosides
Anti-Infective – Carbapenems
Anti-Infective – Macrolides
Anti-Infective – Fluoroquinolones
Anti-Infective – Sulfonamides
Anti-Infective – Tetracyclines
Anti-Infective – Antifungals
Anti-Infective – Antivirals
Anti-Infective – Lincosamide
Thrombolytics
Anticonvulsants
Antidiabetic Agents
Sympatholytics (Alpha & Beta Blockers)
Anti-Infective – Antitubercular
Anti-Infective – Glycopeptide
Bronchodilators
Opioids
Barbiturates
Anesthetic Agents
30- Antineoplastics
Antineoplastics
Alkylating Agents
Antimetabolites
Anti Tumor Antibiotics
Plant Alkaloids Topoisomerase and Mitotic Inhibitors
31 – Medication Infusion
Patient Controlled Analgesia (PCA)
Epidural
Insulin Drips