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ANTACIDS
WHAT ARE ANTACIDS?


Antacids Are A Class (Group) Of Medicines Which Help To Neutralize
The Acid Content Of Your Stomach. Antacids Include: Aluminum
Hydroxide, Magnesium Carbonate, And Magnesium Trisilicate. These
Come In Various Different Brand Names And Are Available As Tablets
And Liquids.



Some Antacids Are Combined With Another Medicine Called
Simethicone Which Helps To Reduce Flatulence (Wind).



Another Group Of Medicines Called Alginates Are Found In Some
Brands Of Antacid Medication. Alginates Are Added To Help Protect
The Lining Of The Esophagus (Gullet) From Stomach Acid. Alginates
Include: Sodium Alginate And Alginic Acid. They Are Present In Antacid
Medications With Various Different Brand Names.
STOMACH AND ACIDITY
ACIDITY IN THE STOMACH


Acidity in the stomach is normal, but
excess acidity is potentially harmful



It is unusual compared to other organs as
its pH is as low as 1-2
Due to production of hydrochloric acid
from structures in lining of walls = gastric
glands



Acid environment kills bacteria that comes
in with food, is optimum for activity of
digestive enzymes
CAUSES OF EXCESSIVE RELEASE OF ACIDS
IN THE STOMACH
•

Alcohol consumption

•

Eating certain foods

•

Anxiety

•

Smoking

•

Certain Drugs, i.e. Aspirin

•

Stress
RESULTS OF EXCESSIVE RELEASE OF HCL IN THE
STOMACH
HEARTBURN

STOMACH
INDIGESTION

ULCERS
ACID

INDIGESTION: feeling of
discomfort due to too much acid in
stomach
HEARTBURN: acid from stomach
rising into esophagus
ULCER: damage to lining of stomach
wall, resulting in loss of tissue and
inflammation
MECHANISM OF ANTACIDS
MECHANISM OF ANTACIDS



Reduction Of Pain Associated With Acid-related Disorders
Allowing The Mucus Layer In The Stomach Lining To Heal.

Treat Ulcers By Preventing The Stomach Acids From
Attacking The Stomach Lining Allowing It To Heal.
 Neutralize Acidity-Increasing The pH
Raising Gastric pH From 1.3 To 1.6 Neutralizes 50% Of The
Gastric Acid.
Raising Gastric pH 1 Point (1.3 To 2.3) Neutralizes 90% Of
The Gastric Acid.

CHARACTERISTICS OF AN IDEAL ANTACID


should not absorbable or cause systemic alkalosis.



should not liberate carbon dioxide &cause rebound hyperacidity.



should not interfere with absorption of food.



should not be a laxative or cause constipation.



should be quick acting & exert its effect over a longer period of time.



should buffer in the pH range 4-6.



should probably inhibit pepsin.



should be inexpensive.
ANTACIDS ARE AVAILABLE AS
 Capsules

 Tablets
 Powders
 Chewable

tablets
 Suspension
TYPES OF ANTACIDS
Types Of ANTACIDS Sodium

Bicarbonate

 Calcium

Salts

 Aluminum

Salts

 Magnesium

 Antacids
 Alginates

Salts

with Antiflatulents
SODIUM CARBONATE
 Highly
 Quick
 May

soluble
onset, but short duration

cause metabolic alkalosis

 Sodium

content may cause problems in
patients with CHF, hypertension, or renal
insufficiency
CALCIUM SALTS


Forms: many, but carbonate is most common



May cause constipation



Their use may result in kidney stones



Long duration of acid action may cause increased
gastric acid secretion (hyperacidity rebound)



Often advertised as an extra source of dietary
calcium
ALUMINUM SALTS
 Forms:

carbonate, hydroxide,
phosphate
 Have constipating effects
 Often used with magnesium to
counteract constipation
MAGNESIUM SALTS
 Forms:

carbonate, hydroxide, oxide,
trisilicate
 Commonly cause a laxative effect
 Usually used with other agents to
counteract this effect
 Dangerous when used with renal failure—
the failing kidney cannot excrete extra
magnesium, resulting in accumulation
ANTACIDS WITH ANTIFLATULENTS
ANTACIDS ANTIFLATULENTS


Activated Charcoal



Simethicone


Alters Elasticity Of Mucus-coated Bubbles, Causing Them To Break.



Used Often, But There Are Limited Data To Support Effectiveness.



Antiflatulents used to relieve the painful symptoms associated with
gas



Several agents are used to bind or alter intestinal gas, and are often
added to antacid combination products.
ALGINATE
Alginate antacids don't work the way other
antacids do. These antacids contain both calcium
carbonate and alginic acid. The alginic acid helps
form a barrier that floats on top of the acid in
your stomach. This barrier helps prevent stomach
acid from moving up into esophagus.
 The calcium carbonate works to neutralize the
stomach acid that pushes through the barrier and
into your esophagus.

SIDE EFFECTS
SIDE EFFECTS OF ANTACIDS
• Loss of
appetite
• Muscle
weakness
• Constipation

• produce a
significant amount
of carbon dioxide
gas, people often
belch
• can cause
metabolic
alkalosis

For
Aluminumcontaining
antacids

For
calciumcontainin
g
antacids:

For sodium
bicarbonat
econtaining
antacids:

• Constipation
• Produces gas
and belching
• may results in
kidney stones

For
magnesiu
m
containin
g
antacids:
•Diarrhea
•Loss of appetite
WHO CANNOT TAKE ANTACIDS
Patient with kidney failure or heart disease: Sodium bicarbonate has high sodium
content and is not appropriate for people who are on salt restricted diets or have
congestive heart failure, high blood pressure, or kidney problems.
In pregnancy: If you are pregnant, antacids are safe to use for heartburn symptoms.
But do not use antacids that have sodium bicarbonate. They can cause fluid buildup.
During pregnancy it is okay to use antacids that have calcium carbonate (such as
Tums).
Problem with liver and kidney : If you have a problem with the function of your
kidneys or liver, you should be careful with using antacids. All drugs are broken down
and removed from the body by the combined action of the liver and kidneys. If your
kidneys are not working correctly, it is possible that too much of the drug will build up
in your body.
DRUG-DRUG INTERACTIONS




When antacids are taken with acidic drugs such as
digoxin , phenytoin , chlorpromazine , isoniazid, they
cause the absorption of the acidic drugs to be
decreased, which causes low blood concentrations of
the drugs, which ultimately results in reduced effects
of the drugs.
Antacids that contain magnesium hydroxide when
taken with some other medications (such as
tetracycline) will bind to the drug, and reduce its
absorption and effects
THANK YOU!

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Antacids

  • 2. WHAT ARE ANTACIDS?  Antacids Are A Class (Group) Of Medicines Which Help To Neutralize The Acid Content Of Your Stomach. Antacids Include: Aluminum Hydroxide, Magnesium Carbonate, And Magnesium Trisilicate. These Come In Various Different Brand Names And Are Available As Tablets And Liquids.  Some Antacids Are Combined With Another Medicine Called Simethicone Which Helps To Reduce Flatulence (Wind).  Another Group Of Medicines Called Alginates Are Found In Some Brands Of Antacid Medication. Alginates Are Added To Help Protect The Lining Of The Esophagus (Gullet) From Stomach Acid. Alginates Include: Sodium Alginate And Alginic Acid. They Are Present In Antacid Medications With Various Different Brand Names.
  • 4. ACIDITY IN THE STOMACH  Acidity in the stomach is normal, but excess acidity is potentially harmful  It is unusual compared to other organs as its pH is as low as 1-2 Due to production of hydrochloric acid from structures in lining of walls = gastric glands  Acid environment kills bacteria that comes in with food, is optimum for activity of digestive enzymes
  • 5. CAUSES OF EXCESSIVE RELEASE OF ACIDS IN THE STOMACH • Alcohol consumption • Eating certain foods • Anxiety • Smoking • Certain Drugs, i.e. Aspirin • Stress
  • 6. RESULTS OF EXCESSIVE RELEASE OF HCL IN THE STOMACH HEARTBURN STOMACH INDIGESTION ULCERS
  • 7. ACID INDIGESTION: feeling of discomfort due to too much acid in stomach HEARTBURN: acid from stomach rising into esophagus ULCER: damage to lining of stomach wall, resulting in loss of tissue and inflammation
  • 9. MECHANISM OF ANTACIDS   Reduction Of Pain Associated With Acid-related Disorders Allowing The Mucus Layer In The Stomach Lining To Heal. Treat Ulcers By Preventing The Stomach Acids From Attacking The Stomach Lining Allowing It To Heal.  Neutralize Acidity-Increasing The pH Raising Gastric pH From 1.3 To 1.6 Neutralizes 50% Of The Gastric Acid. Raising Gastric pH 1 Point (1.3 To 2.3) Neutralizes 90% Of The Gastric Acid. 
  • 10.
  • 11. CHARACTERISTICS OF AN IDEAL ANTACID  should not absorbable or cause systemic alkalosis.  should not liberate carbon dioxide &cause rebound hyperacidity.  should not interfere with absorption of food.  should not be a laxative or cause constipation.  should be quick acting & exert its effect over a longer period of time.  should buffer in the pH range 4-6.  should probably inhibit pepsin.  should be inexpensive.
  • 12. ANTACIDS ARE AVAILABLE AS  Capsules  Tablets  Powders  Chewable tablets  Suspension
  • 14. Types Of ANTACIDS Sodium Bicarbonate  Calcium Salts  Aluminum Salts  Magnesium  Antacids  Alginates Salts with Antiflatulents
  • 15. SODIUM CARBONATE  Highly  Quick  May soluble onset, but short duration cause metabolic alkalosis  Sodium content may cause problems in patients with CHF, hypertension, or renal insufficiency
  • 16. CALCIUM SALTS  Forms: many, but carbonate is most common  May cause constipation  Their use may result in kidney stones  Long duration of acid action may cause increased gastric acid secretion (hyperacidity rebound)  Often advertised as an extra source of dietary calcium
  • 17. ALUMINUM SALTS  Forms: carbonate, hydroxide, phosphate  Have constipating effects  Often used with magnesium to counteract constipation
  • 18. MAGNESIUM SALTS  Forms: carbonate, hydroxide, oxide, trisilicate  Commonly cause a laxative effect  Usually used with other agents to counteract this effect  Dangerous when used with renal failure— the failing kidney cannot excrete extra magnesium, resulting in accumulation
  • 19. ANTACIDS WITH ANTIFLATULENTS ANTACIDS ANTIFLATULENTS  Activated Charcoal  Simethicone  Alters Elasticity Of Mucus-coated Bubbles, Causing Them To Break.  Used Often, But There Are Limited Data To Support Effectiveness.  Antiflatulents used to relieve the painful symptoms associated with gas  Several agents are used to bind or alter intestinal gas, and are often added to antacid combination products.
  • 20. ALGINATE Alginate antacids don't work the way other antacids do. These antacids contain both calcium carbonate and alginic acid. The alginic acid helps form a barrier that floats on top of the acid in your stomach. This barrier helps prevent stomach acid from moving up into esophagus.  The calcium carbonate works to neutralize the stomach acid that pushes through the barrier and into your esophagus. 
  • 22. SIDE EFFECTS OF ANTACIDS • Loss of appetite • Muscle weakness • Constipation • produce a significant amount of carbon dioxide gas, people often belch • can cause metabolic alkalosis For Aluminumcontaining antacids For calciumcontainin g antacids: For sodium bicarbonat econtaining antacids: • Constipation • Produces gas and belching • may results in kidney stones For magnesiu m containin g antacids: •Diarrhea •Loss of appetite
  • 23. WHO CANNOT TAKE ANTACIDS Patient with kidney failure or heart disease: Sodium bicarbonate has high sodium content and is not appropriate for people who are on salt restricted diets or have congestive heart failure, high blood pressure, or kidney problems. In pregnancy: If you are pregnant, antacids are safe to use for heartburn symptoms. But do not use antacids that have sodium bicarbonate. They can cause fluid buildup. During pregnancy it is okay to use antacids that have calcium carbonate (such as Tums). Problem with liver and kidney : If you have a problem with the function of your kidneys or liver, you should be careful with using antacids. All drugs are broken down and removed from the body by the combined action of the liver and kidneys. If your kidneys are not working correctly, it is possible that too much of the drug will build up in your body.
  • 24. DRUG-DRUG INTERACTIONS   When antacids are taken with acidic drugs such as digoxin , phenytoin , chlorpromazine , isoniazid, they cause the absorption of the acidic drugs to be decreased, which causes low blood concentrations of the drugs, which ultimately results in reduced effects of the drugs. Antacids that contain magnesium hydroxide when taken with some other medications (such as tetracycline) will bind to the drug, and reduce its absorption and effects