Silly question:do most patients receive an antiulcer meds while hospitalized?

Nurses General Nursing

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shiccy

379 Posts

Haha,so it is always about the $$$$$$$$$$$$$$....hospitals dont want to get sued for gastric ulcers lol-I wonder if those antiulcer meds will eventually become resistant to ulcers:rolleyes::rolleyes:

:igtsyt: Mm not really.... it's something that is easily prevented (unless contraindicated), totally reimbursable, and the patients are better in the long run for the administration of these meds. It's not about $$ ... Our job is for the patients (or so I've been told ;) ) :nurse:

Specializes in Ortho, Neuro, Detox, Tele.

we give protonix every evening for patients after joint replacement sx, along with their 325 of asa. we have zofran IV throughout their stay available. We encourage them to stick to blander foods, and not recommend the tomato/acid foods until the last day of their stay.

cb_rn

323 Posts

Specializes in CT stepdown, hospice, psych, ortho.
Lovenox is very expensive, if i recall correctly, over $100 per injection, still minute to the financial, let alone physical reprocussions of a DVT/PE/MI. That being said, the ever popular protonix is only $30 for the IV and less for the PO, pretty much every patient on our med/surg floor is on either protonix or pepcid, reglan I have not seen used prophylactically other than for nausea and increasing bowel motility. But speaking of protonix, did everyone know it can show up as a false positive for a urine drug screen for THC? Just FYI showing I actually did take the time to read the insert that comes with the vial.

I started a thread on that about 3 weeks ago. I was very surprised myself!

I don't know what made our docs start using reglan but from my nursing practice I can see a difference in how fast the bowel sounds return. Not really sure if it results in better outcomes, I've noticed the appetite doesn't come back any quicker.

Specializes in CCU MICU Rapid Response.

Hey there, I work in an large ICU, and we administer protonix IV daily until they transition and are able to take po, then prevacid or po protonix starts. It is part of our vap protocol. :) Ivanna

Quienes

54 Posts

Hi,

Did someone say Lovenox helps to prevent pressure ulcers?

Specializes in OR, peds, PALS, ICU, camp, school.

There are so many thoughts mixed up in my mind right now. I hate posts that reply in a list but I've gotta do here.

-peptic ulcer prophylaxis and DVT prophylaxis are big these days. It's not really because litigation has increased but because knowledge and awareness has increased. H2 inhibitors and proton pump inhibitors were brand new when I was a student... not even OTC. Lovenox was brand new also.

- VAP prophylaxis is ICU is including chlorhexidine mouthwash as a standard more and more.

- yes, it's cost saving. Saves the hospital $, saves the pt $, saves insurance $, saves everyone who makes a paycheck or pays taxes $. So what? Now, with insurance companies able to turn down payment for hospital acquired conditions, it's a huge deal.

- We stop PUD prophy when the pt is able to tolerate TF at goal rates. Oral PUD prophy continues with PO fed pts. I'd actually like to read more on this rationale. Guess it's time for a lit search.

- Lovenox is pricey. Heparin is pretty cheap. All costs depend on the negotiation skills of hospitals and distribution companies. We use unfractionated heparin when we can. Rarely we use lovenox or fragmin. If we're dealing with HIT, it's a whole 'nother story.

- Heparins, early ambulations, and SCD's prevent DVT. No impact on pressure ulcers in any research I've read. Anyone have a source that says otherwise (for heparins, I mean?) I'm curious.

- Early ambulations, good mattresses, skin care, booties, and good old turn q2 are really neccessary to prevent pressure ulcers. Remember back rubs? Oooh, relaxing! They help, too. Throw a 40 second rub with some cream into your turn routine.

- Maybe when we prevent the preventable and are able to be reimbursed for what we do (and only do what's reimburable) we'll be able to afford more staff again? And have time for the good nursing care that prevents complications. Or maybe we'll be able to afford prettier lobbies and waiting rooms. Yeah. Probably prettier decor. :mad:

RaeRae1997

30 Posts

Specializes in CICU, radiology, psych.

We put all our vent patient's on peptic ulcer meds to decrease incidence of VAP.

Specializes in Medsurg/ICU, Mental Health, Home Health.
You need to think like this? If you're talking about a bed sore ulcer, or a gastric ulcer it doesn't matter.

A tiny injectable of lovenox cost maybe a dollar. The cost to heal a bed sore is insaine maybe $10,000, and the cost of a perforating gastric ulcer leading to peritonitis....... I'm not sure i want to know.

I read and reread this post, but I still don't understand what Lovenox has to do with anything...

msjellybean

277 Posts

Specializes in Emergency.
I read and reread this post, but I still don't understand what Lovenox has to do with anything...

Neither do I.

And as echoed by others, Lovenox is not cheap. My mom had a total hip two summers ago and come home on 30mg once a day x21 days. The part that insurance picked up was well over $1000. And I believe her co-pay was upwards of $200. I shudder to think how much the Lovenox cost will be to one of my patients from last night. He was discovered to have a LUE DVT and is now on Lovenox 100mg q12 hours.

Redhead28

200 Posts

Specializes in Peds, PACU, ICU, ER, OB, MED-Surg,.

JCAHO checks that hospitals routinely prevent ulcers d/t stress. Also check for DVT prevention. Hospitals are audited on these things.

Danielsonrg

22 Posts

Lovenox is actually really expensive. Really, really expensive.

But your point is well taken. An ounce of prevention

Yea my bad, a patient was discharged the other day on a two weeks supply of lovenox and his insurance was billed $140 or $120. So it's about ten dollars a shot

............... I suppose I could make a million dollars if I make warfarin IV and have a rapid onset....... LMWH producers would go out of buisnesss.

say you want to start a buisness together. all we need is some rat poison a spoon and a lighter.

(god it sounds like a meth recipe)

Danielsonrg

22 Posts

Lovenox is very expensive, if i recall correctly, over $100 per injection, still minute to the financial, let alone physical reprocussions of a DVT/PE/MI. That being said, the ever popular protonix is only $30 for the IV and less for the PO, pretty much every patient on our med/surg floor is on either protonix or pepcid, reglan I have not seen used prophylactically other than for nausea and increasing bowel motility. But speaking of protonix, did everyone know it can show up as a false positive for a urine drug screen for THC? Just FYI showing I actually did take the time to read the insert that comes with the vial.

A hundred per injection..... Wow someone is really taking it for that price. Why I can find it on google from Canada for less than ten dollars...... I guess maybe we need to just get fake candian passports to solve our health care issuses related to pharmacologic substances

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