A Physician has ordered Ranitidine (Zantac) 300 mg once a day (OD). At what time will a Nurse give this medicine from the following?

Appeared in: Uttarakhand CHO - 2021

Explanation

Ranitidine is a Histamine-2 (H₂) receptor antagonist used to decrease stomach acid production.
Gastric acid secretion is naturally highest during the night (nocturnal secretion).
A single daily dose (300 mg) is administered at bedtime (HS) to maximally suppress this nocturnal acid production.
This timing promotes the healing of peptic ulcers and provides effective overnight symptom relief for conditions like GERD.

Option A: This timing is optimal for a different class of acid-reducing drugs, Proton Pump Inhibitors (PPIs).
Option B: This timing does not coincide with the peak period of gastric acid secretion and offers no specific therapeutic advantage for a once-daily dose.
Option C: Adding sugar is not a valid administration instruction and has no bearing on the drug's efficacy or mechanism.

Clinical Relevance

Nursing practice connection: Knowing Pharmacology: Administration timing of H2-receptor antagonists helps nurses interpret findings accurately and avoid errors in routine assessment, medication administration, and patient teaching.
A key nursing responsibility is patient education on correct medication timing to ensure therapeutic effectiveness.
Nurses should advise patients to avoid gastric irritants like smoking, alcohol, and NSAIDs, as these can counteract the medication's effects and delay ulcer healing.
Monitor for CNS side effects like confusion and dizziness, especially in elderly patients receiving H₂ blockers.

How to Approach the Question

First, identify the drug mentioned in the question: Ranitidine (Zantac).
Next, classify the drug. Ranitidine is a Histamine-2 (H₂) receptor antagonist.
Recall the primary mechanism and therapeutic goal for this drug class, which is to suppress gastric acid, particularly the high levels produced at night.
Analyze the prescription: '300 mg once a day (OD)'. A single daily dose regimen requires timing it for maximum effect.
Evaluate the options based on the drug's mechanism. 'At bedtime' directly targets the period of highest acid secretion, making it the most logical and effective choice for a once-daily dose.

Concept Tested & Keywords

Q7NI6cfRkXwgwvcU6Pcaot

E6 Pharmacology KD Tripathi Essentials 9e Part 2 p. 324-326

E6 Pharmacology Nursing Lilley 11e Part 3 p. 167-169

Practise the full Uttarakhand CHO - 2021

Attempt every question from this paper in a timed mock, then review the full solution for each one.