Antacids

pharmacology of antacids, Ulcers its types, causes, treatments and description of ulcers with a detailed note on Antacids

1. Antacids KRVS Chaitanya

2. What are antacids? An  antacid  is a substance which neutralizes stomach acidity and is used to relieve heartburn, indigestion or an upset stomach, some times constipation and diarrhea.. They contain ingredients such as aluminium , calcium , magnesium , or sodium bicarbonate which act as bases (alkalis) to counteract stomach acid and make its pH more neutral.

3. Which antacid is used for? When antacids are used Indigestion .  Heartburn or acid reflux  – also known as gastro-oesophageal reflux disease (GERD) a stomach ulcer. Gastritis (inflammation of the stomach lining)

4. Medical uses: Antacids are available over the counter and are taken by mouth to quickly relieve occasional  heartburn , the major symptom of  gastroesophageal reflux disease  and  indigestion. Treatment with antacids alone is  symptomatic  and only justified for minor symptoms. Alternative uses for antacids include constipation, diarrhea, hyperphosphatemia, and urinary alkalization.

5. Non-particulate antacids (sodium citrate, magnesium trisilicate) increase gastric pH with little or no effect on gastric volume, and therefore may see some limited use in pre-operative procedures. Sodium citrate should be given within 1 hour of surgery to be the most effective.

6. How antacids work Antacids are over-the-counter (OTC) medications that help neutralize stomach acid. They work differently from other acid reducers such as  H2 receptor blockers  and proton pump inhibitors (PPIs). Those drugs work by reducing or preventing the secretion of stomach acid.

7. Antacids can be used to treat symptoms of excess stomach acid, such as: acid reflux, which can include Regurgitation Bitter taste Persistent dry cough Pain when lying down Trouble swallowing heartburn.

8. What is ANC The  acid neutralizing capacity  (ANC) of an antacid is the amount of acid that it can neutralize . The moles of acid neutralized equals the difference between the moles of acid added and the moles of base required for the back titration . Acid-neutralizing capacity  or  ANC  in short is a measure for the overall buffering capacity against acidification of a solution, e.g. surface water or soil water.

9. Types of antacids Antacids usually come in the following drug forms: Liquid Chewable gummy or tablet Tablet that you dissolve in water to drink

10. Precautions Antacids are typically safe for most people. However, people with certain medical conditions should talk with their doctors before taking certain antacids that contain aluminium hydroxide and magnesium carbonate. For example, people with  heart failure  may have sodium restrictions to help decrease fluid build-up.

11. People with  kidney failure may develop a build-up of aluminium after using antacids. This can lead to aluminium toxicity . People with kidney failure also tend to have problems with  electrolyte balance . All antacids contain electrolytes, which could make electrolyte balance problems worse. Children don’t typically develop symptoms of excess stomach acid, so their symptoms could be related to another condition.

12. Side effects of antacids Side effects from antacids are rare . However, they can occur, even when you use them according to the directions. Antacids can either cause  constipation  or have a laxative effect. Some people have had  allergic reactions and flatulence too Antacids might also increase the risk of developing sensitivities to certain foods

13. Formulations containing magnesium salts may cause diarrhea, whereas those containing calcium or aluminium may cause constipation. Rarely , long-term use of calcium carbonate may cause kidney stones. Long-term use of antacids containing aluminium may increase the risk of developing  osteoporosis. 

14. Side effects from misuse Many of the side effects of antacids come from not taking them as directed. If you take too much or take them for longer than directed, you could get an overdose of calcium.  Too much calcium can cause: Nausea Vomiting Mental status changes Kidney stones

15. Excess calcium can also lead to  alkalosis. In this condition, your body doesn’t make enough acid to function properly. If you feel like you need to use a lot of an antacid for relief, that might be a sign of another condition. If you’ve taken an antacid according to the directions and haven’t gotten relief, talk to your doctor.

16. Mechanism of action When an excess amount of acid is produced in the stomach, the natural mucous barrier  that protects the lining of the stomach can degrade , leading to pain and irritation. There is also potential for the development of  acid reflux, which can cause pain and damage to the oesophagus.

17. Antacids contain  alkaline ions that chemically neutralize  stomach gastric acid, reducing damage to the stomach lining and oesophagus, and relieving pain.  Some antacids also inhibit pepsin , an enzyme that can damage the oesophagus in acid reflux.

18. Antacids do not directly inhibit acid secretion , and thus are distinct from acid-reducing drugs like  H 2 -receptor antagonists or proton pump inhibitors (PPIs).   Antacids do not kill the bacteria  Helicobacter pylori , which causes most ulcers.

19. Formulations Antacids may be formulated with other active ingredients such as  simethicone  to control gas , or  alginic acid  to act as a physical barrier to acid. Liquids Milk of magnesia Magnesium/ aluminium combinations. (Quicker relief)

20. Tablets Chewable tablets Common salts available in tablet form include those of calcium, magnesium, aluminium, and sodium. Effervescent tablet Effervescent tablets are tablets which are designed to dissolve in water, and then release carbon dioxide. 

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