The nurse is reviewing the medication record of a client with acute gastritis. Which medication, if noted on the client’s record, would the nurse question?
A. digoxin (Lanoxin)
B. indomethacin (Indocin)
C. furosemide (Lasix)
D. propranolol hydrochloride (Inderal)
Correct Answer: B. indomethacin (Indocin)
Indomethacin (Indocin) is an NSAID and can cause ulceration of the esophagus, stomach, duodenum, or small intestine. Indomethacin is contraindicated in a client with GI disorders. Nonsteroidal anti-inflammatory drugs (NSAIDs) such as indomethacin are capable of producing injury to gastrointestinal mucosa in experimental animals and humans, and their use is associated with a significant risk of hemorrhage, erosions, and perforation of both gastric and intestinal ulcers
Option A: Digoxin is not contraindicated for acute gastritis. The molecular basis for the gastrointestinal toxicity of NSAIDs is widely believed to be their inhibitory activity against cyclooxygenase, which causes them to block the production of prostaglandins and their therapeutic actions.
Option C: The Food and Drug Administration (FDA) has approved furosemide to treat conditions with volume overload and edema secondary to congestive heart failure exacerbation, liver failure, or renal failure, including nephrotic syndrome. It is not contraindicated in a client with gastritis.
Option D: Propranolol can be used to ameliorate the sympathetic response in angina, tachyarrhythmias, prevention of acute ischemic attacks, migraine prophylaxis, and restless leg syndrome. Propranolol can be used in almost all cases if the desired result is to slow contractility and decrease a patient’s heart rate.
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