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Antacids: Action Mechanism

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ANTACIDS

Antacids are medicines that neutralize stomach acid. They are


used to relieve acid indigestion, upset stomach, sour stomach,
and heartburn.
Antacids are taken by mouth and work by neutralizing excess
stomach acid. They contain ingredients such as aluminum
hydroxide, calcium carbonate, magnesium hydroxide, and
sodium bicarbonate, alone or in various combinations.
Antacid products may also contain other ingredients such as
simethicone, which relieves gas.
Antacids differ in how quickly they work and how long they
provide relief. Those that dissolve rapidly in the stomach,
such as magnesium hydroxide and sodium bicarbonate, bring
the fastest relief. Antacids that contain calcium carbonate or
aluminum dissolve more slowly and can take up to 30 minutes
to begin working. The longer an antacid stays in the stomach,
the longer it works. Those that contain calcium carbonate or
aluminum work longer than those that contain sodium
bicarbonate or magnesium. Also, taking any kind of antacid
after a meal, instead of on an empty stomach, provides longer-
lasting relief because the medicine stays in the stomach.

ACTION MECHANISM:-
Antacids perform a neutralization reaction, i.e. they buffer
gastric acid, raising the pH to reduce acidity in the stomach.
When gastric hydrochloric acid reaches the nerves in the
gastrointestinal mucosa, they signal pain to the central
nervous system. This happens when these nerves are exposed,
as in peptic ulcers. The gastric acid may also reach ulcers in
the esophagus or the duodenum.
Other mechanisms may contribute, such as the effect of
aluminium ions inhibiting smooth muscle cell contraction and
delaying gastric emptying.

USES OF ANTACIDS:-
ANTACIDS is used for the treatment of :

 Indigestion
 Gastritis
 Heartburn
 peptic ulcers
 and other digestive problems.

INDIGESTION
Indigestion, also known as dyspepsia, is a term used to
describe one or more symptoms including a feeling of fullness
during a meal, uncomfortable fullness after a meal, and
burning or pain in the upper abdomen. It is also referred to as:
 sour stomach

 acid indigestion

 upset stomach

 acid stomach

Antacids can be used to treat these symptoms.


GASTRISIS
Gastritis means inflammation of the stomach. It means that
white blood cells move into the wall of the stomach as a
response to some type of injury. Gastritis does not mean that
there is an ulcer or cancer. It is simply inflammation–either
acute or chronic.

HEARTBURN
Heartburn is an uncomfortable but common feeling of burning
or warmth in the chest. Although the pain of heartburn is felt
in the chest, heartburn has nothing to do with your heart.
Instead, heartburn is caused by stomach acid.

PEPTIC ULCERS
A peptic ulcer is a sore in the lining of your stomach or
duodenum. The duodenum is the first part of your small
intestine. A peptic ulcer in the stomach is called a gastric
ulcer. One that is in the duodenum is called a duodenal ulcer.
A peptic ulcer also may develop just above your stomach in
the esophagus, the tube that connects the mouth to the
stomach. But most peptic ulcers develop in the stomach or
duodenum.

Harmful Effects of Antacids:-


Excess calcium from supplements, fortified food and high-
calcium diets, can cause the milk-alkali syndrome, which has
serious toxicity and can be fatal.
Fortunately, because acid reflux is such a common problem,
antacids are among the medicines available and free of side
effects for most people. Side effects from antacids vary
depending on individual and other medications they may be
taking at the time. Those who experience side effects most
commonly suffer from changes in bowel functions, such as
diarrhea, constipation, or flatulence.
Although reactions to any drug may vary from person to
person, generally those medications that contain aluminum or
calcium are the likeliest to cause constipation, those that
contain magnesium are the likeliest to cause diarrhea. Some
products combine these ingredients, which essentially cancels
them out, to forestall unpleasant side effects.
In general, people with kidney problems should probably not
take antacids as this can sometimes cause a condition known
as alkalosis. In other people, side effects may occur if
substances such as salt, sugar, or aspirin, are added to a
particular medication. As with all medications, always
carefully read the product label on the package and check with
your doctor or pharmacist if you have any question about
potential drug interactions or side effects.
Some side effects, such as constipation and diarrhea, are fairly
obvious. Other more serious side effects, such as stomach or
intestinal; bleeding, can be more difficult to recognize. In
general, any sign of blood in the stool or the presence of
vomiting is a danger sign and should be brought to the
immediate attention of a physician.
If your symptoms persist for more than 10 days to two weeks
while you are using the medication, you should stop taking it
and consult your doctor. Persistent symptoms may indicate
that you have more a serious problem than occasional acid
reflux. Pregnant or nursing baby should always consult your
doctor before taking this medication. Generally, you should
not give these medications to children under the age of 12
unless under the advice and supervision of your doctor or the
package label has indicated that the product is safe for young
children. Constant use of antacids leads to a condition called
acid rebound where the stomach begins to over secrete acid in
order to make up for the quantity that is being neutralized.
Other adverse effects from antacids include:
1. Carbonate : Regular high doses may cause alkalosis,
which in turn may result in altered excretion of other drugs,
and kidney stones. A chemical reaction between the carbonate
and hydrochloric acid may produce carbon dioxide gas. This
causes gastric distension which may not be well tolerated.
Carbon dioxide formation can also lead to headaches and
decreased muscle flexibility.
2. Aluminum hydroxide : May lead to the formation of
insoluble aluminium-phosphate-complexes, with a risk for
hypophosphatemia and osteomalacia. Although aluminium
has a low gastrointestinal absorption, accumulation may occur
in the presence of renal insufficiency. Aluminium-containing
drugs may cause constipation.
3. Magnesium hydroxide : Has laxative properties.
Magnesium may accumulate in patients with renal failure
leading to hypermagnesemia, with cardiovascular and
neurological complications. See Milk of magnesia.
4. Sodium : Increased intake of sodium may be deleterious
for arterial hypertension, heart failure and many renal
diseases.

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