Sources: Medline Plus, WebMD, Drugs.com, Cleveland Clinic, KAPLAN NCLEX Medication Review Ninth Edition
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Pantoprazole is a gastrointestinal medication you need to master for the pharmacology section on the Next Generation NCLEX.
In this episode, we’ll go over everything you need to know about it, from what it’s used for to its adverse effects to nursing considerations.
But that’s not all!
As always, I’ll also be going through a few questions and answers so you can practice your knowledge for the NCLEX.
Are you ready?
Let’s dive in!
Everything You Need to Know About Pantoprazole
Pantoprazole is a commonly used proton-pump inhibitor. We give pantoprazole to treat GERD and ulcers (as well as prevent them). When the stomach is producing too much acid, we prescribe pantoprazole to decrease the acid production.
How Do Proton-Pump Inhibitors Work?
Proton-pump inhibitors block the hydrogen-potassium ATPase enzyme system, which is the gastric proton-pump.
What does this gastric proton-pump do? It works by secreting hydrochloric acid in the stomach. If the proton-pump inhibitor inhibits this pump, meaning if it stops it from working, then the final step of the gastric acid production does not happen. This reduces acid secretion and the individual taking the proton-pump inhibitor can get relief from symptoms and the damaged gastric tissues can start to heal.
Other proton-pump inhibitors are omeprazole, lansoprazole, and esomeprazole. They all have one thing in common: They end in -prazole, just like pantoprazole.
The Side-Effects of Pantoprazole
- Headache
- Abdominal pain
- Diarrhea
- Rash
- Hyponatremia
- Hypomagnesemia
- Muscle pain
Nursing Considerations
- Pantoprazole can be taken with or without food.
- Report to the healthcare provider if there is black tarry stools, reports of severe abdominal pain, or diarrhea.
- Those taking pantoprazole must avoid alcohol, aspirin, or NSAIDs.
- Vitamin B12 deficiency may be a long-term complication that can occur with ongoing pantoprazole administration.
- Pantoprazole can interact with drug absorption, such as iron supplements.
- Pantoprazole can increase the effectiveness of warfarin, which can increase bleeding risk.
- Do not double dose if the first dose is missed.
Pantoprazole is safe to take, but note that many of the nursing considerations have to do with bleeding risks. When you answer NCLEX questions, pay attention to choices that can cause bleeding risks to increase.
Pantoprazole Questions and Answers
Question #1: The nurse is reviewing the laboratory results for a patient who is about to take pantoprazole as directed. Which of the following results warrants the nurse to withhold the medication and inform the healthcare provider?
Serum magnesium 1.2 mg/dL
Serum magnesium 2.2 mg/dL
Serum potassium 5 mEq/L
Serum sodium 150 mEq/L
Answer: Serum magnesium 1.2 mg/dL.
Rationale: Hypomagnesemia is an adverse effect of pantoprazole administration and if the serum magnesium level is low, the nurse should notify the healthcare provider before administration. The potassium level is normal and does not need to be questioned. While the sodium level is on the higher side, hyponatremia is the adverse effect of pantoprazole administration.
Question #2: The nurse is providing care for a patient diagnosed with GERD. Which of the following statements from the patient indicate that further teaching is necessary?
“I should not double dose if I missed my first dose.”
“I should report if I am experiencing black tarry stools.”
“I should not take warfarin with pantoprazole.”
“I can take ibuprofen with pantoprazole.”
Answer: “I can take ibuprofen with pantoprazole.”
Rationale: Taking ibuprofen with pantoprazole can increase bleeding risk so further teaching is necessary. Double dosing should not occur if the dosage is missed. Black tarry stools should be reported. Warfarin should not be taken with pantoprazole due to an increase in bleeding risk.
Question #3: The nurse is providing care for a patient that took pantoprazole an hour ago. Now the patient is reporting that he feels dizzy and is having a rapid heart rate. What should be the next step?
Tell the patient to stop taking the medication.
Notify the healthcare provider.
Take the patient’s blood pressure.
Check the patient’s electrolyte levels.
Answer: Check the patient’s electrolyte levels.
Rationale: The patient already took pantoprazole and is already experiencing side effects. Telling the patient to stop taking the medication will not resolve the issue. There are other choices to take prior to notifying the healthcare provider. Taking the blood pressure is not the next step to take because pantoprazole does not affect the blood pressure. Checking the electrolyte levels is the necessary next step to take since electrolyte imbalances can occur, such as low sodium and low magnesium levels.
Question #4: The nurse is providing care for a patient who has been prescribed pantoprazole for the first time. Which of the following patient statements would indicate that further teaching is required?
“I should report any bleeding or bruising.”
“I will stop taking the medication after my symptoms have been alleviated.”
“I should not take warfarin with this medication.”
“I may experience side effects, such as headaches.”
Answer: “I will stop taking the medication after my symptoms have been alleviated.”
Rationale: The patient should not stop the medication administration once symptoms have been alleviated because the symptoms can come back. Instructions must be followed regarding the therapy’s duration. Side effects, such as headaches, may occur. Warfarin should not be taken with pantoprazole due to bleeding risk. Since there’s potential for bleeding risk, bleeding or bruising should be reported.
Question #5: The nurse is reviewing the patient’s medication list and notes a history of pantoprazole administration. The nurse is aware that a potential long-term risk associated with pantoprazole is which of the following?
Magnesium deficiency
Vitamin B12 deficiency
Hyperglycemia
Both 1 and 2
Answer: Both 1 and 2.
Rationale: Magnesium deficiency and vitamin b12 deficiency are both potential long-term risks associated with long-term use of pantoprazole. Hyperglycemia is not a long-term risk that would be noted with pantoprazole.
Pantoprazole True or False Statements
Statement #1: Vitamin B12 deficiency may be a long-term complication of pantoprazole.
This statement is true.
Statement #2: Black tarry stools must be reported to the healthcare provider with pantoprazole administration.
This statement is true.
Statement #3: Ibuprofen can be taken with pantoprazole.
This statement is false. Ibuprofen should be avoided with pantoprazole due to bleeding risk.
Statement #4: Pantoprazole is given to treat ulcers, but not to prevent ulcers.
This statement is false. Pantoprazole is given both to treat ulcers and to prevent ulcers.
Statement #5: Constipation should be reported to the healthcare provider after pantoprazole administration.
This statement is false. Diarrhea should be reported to the healthcare provider after pantoprazole administration.
