Antacids
Antacids
Antacids are over-the-counter (OTC) medications that are used as adjunct therapy to treat peptic ulcers. They include:
- aluminum carbonate gel
- calcium carbonate
- magaldrate (aluminum-magnesium complex)
- magnesium hydroxide and aluminum hydroxide
- simethicone.
Pharmacokinetics
Antacids work locally in the stomach by neutralizing gastric acid. They don’t need to be absorbed to treat peptic ulcers.
Distribution and excretion
Antacids are distributed throughout the GI tract and are eliminated primarily in stool.
Pharmacodynamics
The acid-neutralizing action of antacids reduces the total amount of acid in the GI tract, allowing peptic ulcers to heal.
The more it works, the sooner it rests
Pepsin, one of the stomach secretions, acts more effectively when the stomach is highly acidic; therefore, as acidity drops, pepsin action is also reduced. Contrary to popular belief, antacids don’t work by coating peptic ulcers or the lining of the GI tract.
Warning!
Adverse reactions to antacids
All adverse reactions to antacids are dose related and include:
- diarrhea
- constipation
- electrolyte imbalances
- aluminum accumulation in serum.
Pharmacotherapeutics
Antacids are primarily prescribed to relieve pain and are used adjunctively in peptic ulcer disease.
Settling the GI system
Antacids also relieve symptoms of acid indigestion, heartburn, dyspepsia (burning or indigestion), or gastroesophageal reflux disease (GERD), in which the contents of the stomach and duodenum flow back into the esophagus.
Fighting phosphate
Antacids may be used to control hyperphosphatemia (elevated blood phosphate levels) in kidney failure. Because calcium binds with phosphate in the GI tract, calcium carbonate antacids prevent phosphate absorption.
Drug interactions
All antacids can interfere with the absorption of oral drugs given at the same time. Absorption of digoxin, phenytoin, ketoconazole, iron salts, isoniazid, quinolones, and tetracyclines may be reduced if taken within 2 hours of antacids.
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