A client with hepatitis C has been experiencing symptoms of gastroesophageal reflux.
What H antagonist would be most appropriate for this client’s needs?

Famotidine is a histamine type 2 receptor antagonist (H blocker) which is commonly used for treatment of acid-peptic disease and heartburn. Famotidine has been linked to rare instances of clinically apparent acute liver injury, but it is less likely to cause hepatotoxicity than cimetidine, another H blocker. Famotidine also has fewer drug interactions than cimetidine.

Choice A is wrong because nizatidine is another H blocker that can cause mild and transient serum aminotransferase elevations.

Nizatidine has not been linked to cases of clinically apparent liver injury, but it has not been widely used.

Choice B is wrong because ranitidine is another H blocker that can cause mild and transient serum aminotransferase elevations.

Ranitidine has also been associated with rare instances of clinically apparent liver injury, some of which were fatal or required liver transplantation.

Choice C is wrong because cimetidine is another H blocker that can cause mild and transient serum aminotransferase elevations.

Cimetidine has also been implicated in several cases of clinically apparent acute liver injury, some of which were severe and led to acute liver failure and death.

Cimetidine also has many drug interactions due to its inhibition of cytochrome P enzymes.

Normal ranges for serum aminotransferases are 7 to 56 U/L for alanine aminotransferase (ALT) and 10 to 40 U/L for as

This is because a nutritious diet provides adequate fiber and nutrients for the GI tract, avoiding alcohol prevents dehydration and irritation of the GI mucosa, and cautious use of laxatives prevents dependency and electrolyte imbalance.

Choice A is wrong because caffeine can stimulate the GI motility and cause diarrhea or cramps.

Choice C is wrong because some prescription medications can affect the GI function, such as antibiotics, opioids, or antacids.

Increased fluid intake is good, but not enough to promote optimal GI function.

Vigorous exercise can also cause GI distress or dehydration.

Choice D is wrong because adequate fluid intake is essential for preventing constipation and maintaining hydration.

Exercise can also help with bowel movements and overall health.

Normal ranges for GI function vary depending on the individual, but generally, a person should have at least one bowel movement every 3 days and no more than 3 bowel movements per day.

The stool should be soft, formed, and easy to pass.