Anda di halaman 1dari 19

ANTACID PRODUCTS

PREPARED BY :THERESIA SHEMSIKA Click to edit Master subtitle style

5/1/12

GASTRIC ACID SECRETION

Secreted by the parietal cells of the stomach. The outer membrane of the parietal cells contain receptors for histamine from mast cells, Ach from nerve endings and gastrin which reaches the cells from a distant site. When these receptors are stimulated acid is secreted via H/K pump.
5/1/12

functions of the acid

Gastric acid and pepsin are powerful proteolytic agents that aid in the digestion and absorption of food. Gastric acid also kills most bacteria in the stomach and helps to maintain a stable stomach environment.

5/1/12

Control of the acid secretion

Anticholinergics inhibit the secretion eg.pirenzenpine M1 antagonist. H2 antagonist reduce acid secretion by blocking histamine receptors.eg cimetidine . Proton pump inhibitors eg omeprazole. Gastrin increase secretion. The epithelial cells 5/1/12 secrete mucus and bicarbonate to

Factors increasing acid secretion

Zollinger Ellison syndrome(gastinoma), hypersecretion of the acid causing intractable peptic ulcer disease. Beer, coffee,and tea are said to increase acid secretion.

5/1/12

Factors disrupting the mucosal barrier

Helicobacter pylori which produces enzymes that degrades the gastric mucosa NSAIDS eg aspirin Smoking Alcohol Other drugs eg immunosuppressive agents.
5/1/12

Antacids

These agents neutralize the acid that was secreted, they have no effect on the amount and the rate of acid secretion. They increase the pH in the stomach and duodenal bulb. All antacids are basic compounds that react with the acid to form salt and water.
5/1/12

Cont.
The commonly used compounds are;

Sodium bicarbonate Calcium carbonate Aluminum salts ( hydroxide, phosphate)and Magnesium salts (hydroxides, chlorides)

All antacids contain at least one of 5/1/12 these ingredients which differ in

Sodium bicarbonate

Is a potent, highly soluble compound that react with the acid to form sodium chloride, carbon dioxide and water. Is a systemic antacid meaning it is completely absorbed and affect systemic pH. Most of the side effects are due to systemic absorbed antacid. These 5/1/12 can be ;

Cont.
Milk alkali syndrome(systemic alkalosis) can occur when sodium bicarbonate is taken together with calcium.

Symptoms of the syndrome are hypercalcemia, alkalosis, irritability, headache ,vertigo, nausea, vomiting, weakness myalgia. Another problem is sodium overload.
5/1/12

Because of these, sodium bicarbonate

contraindications

Patients with edema Congestive heart failure Renal failure Cirrhosis Hypertensive pts and Pts on low salt diet
5/1/12

Calcium carbonate

Dissolves more slowly than sodium bicarbonate but produces a potent and more prolonged neutralization of the acid to produce calcium chloride, carbon dioxide and water. Is a non systemic antacid The main problem with this is acid rebound Can cause flatulence just like sodium 5/1/12 bicarbonate due to carbon dioxide

Aluminum hydroxide

Is slowly dissolved in the stomach where it reacts with acid to form aluminum chloride and water. The most side effect of this is constipation which is said to be due to inhibition of intestinal smooth muscle contraction by the aluminum ion. This constipation is dose related and 5/1/12 may be corrected.

Magnesium hydroxide

Reacts with the acid to produce potent short acting neutralizing action by forming magnesium chloride. The most frequent side effect of magnesium containing antacids is diarrhea which may be severe to cause fluid and electrolyte imbalance. This diarrhea is dose related and it

5/1/12

Aluminum-magnesium combination

Allows for low doses of each agent. Constipation from aluminum and diarrhea from magnesium are taken care of. Magaldrate is a chemical mixture of Al and Mg with a lower neutralizing capacity than physical Al Mg mixture.

5/1/12

Onset and duration of action of antacids

Onset of action depends on solubility (how fast the antacids dissolves in the acids) which also depends on physical and chemical properties. Sodium and magnesium containing antacids dissolve quickly at gastric pH. Al and Mg containing antacids dissolve slowly.
5/1/12

Cont.

The duration of action is determined by how long the antacids remains in the stomach and is dependent on gastric emptying time. Antacids should not be taken on an empty stomach, should be taken 1hr after food because gastric emptying at that time is slow. Mg and sodium antacids have 5/1/12 shortest duration of action, Al and Ca

Antacid- drug interactions

The most well known drug interaction with antacids is that of tetracycline. The cations have high affinity for tetracycline forming chelate that can not be absorbed hence inhibiting the absorption of antibiotics. Antacids interfere the absorption of drugs requiring acidic pH, eg sucrafate.
5/1/12

Interference with the renal

The things that we overlook and take for granted the ones that matters a lot.

5/1/12

Anda mungkin juga menyukai