NR565 Week 7 Study Guide _ Lesson Notes
Management of GI Discomfort
Click on each category below to explore its characteristics further.
ANTACIDS
Antacids neutralize acids in the gastrointestinal (GI) tract. Different combinations have
differing acid neutralizing capacities. Sodium bicarbonate and calcium carbonate have
the highest absolute neutrophil count (ANC).
Pharmacodynamics
Antacids neutralize gastric acid in the gastrointestinal (GI) tract. Causing an increased
pH in the stomach and the duodenal bulb. Antacids contain various combinations of
metallic cation.
Metallic cation + basic ion
Common metallic cation
Aluminum
Calcium
Magnesium
Basic anion
Hydroxide
Bicarbonate
Carbonate
Different combinations have differing acid neutralizing capacities.
Sodium bicarbonate and calcium carbonate have the highest absolute neutrophil
count (ANC).
Pharmacokinetics
Aluminum- and magnesium-based antacids are not absorbed with normal routine use.
Chronic use increases absorption by 5%-20%. Renally excreted. Calcium-containing
antacids require vitamin D for absorption. Excreted in feces
Clinical Uses:
Hyperacidity: antacids used for symptomatic relief of heartburn
May take four times per day (QID) or more
Discuss maximum dosages with patient
Peptic ulcer disease
May be used as adjunct to peptic ulcer disease (PUD) triple therapy treatment
, Used after meals and at bedtime
Gastroesophageal reflux disease (GERD)
Antacids are over-the-counter (OTC) and often-used first before patient seeks
care.
May be given every 30 to 60 minutes until symptoms subside
Maintenance after meals and bedtime
Histamine2 receptor antagonists or proton pump inhibitors (PPIs) are first-line
therapy.
Calcium deficiency
Chronic renal failure: 1,000 mg calcium
carbonate daily
Osteoporosis prevention
Men and premenopausal women: 1,000 mg daily
Postmenopausal women: 1,500 mg daily
Doses higher than 2,000 mg/day not recommended
Rational Drug Selection
Combination products have the highest ANC
Sodium content
Cost
OTC
Inexpensive, but may vary
Generics OK
Monitoring
Magnesium level in elderly patients who use magnesium-containing products
chronically
Precautions and contraindications
Abdominal pain of unknown cause
Calcium-based antacids contraindicated if patient is hypercalcemic or has renal
calculi.
Magnesium-based antacids are contraindicated in patients with renal failure or
renal insufficiency.
Aluminum-based antacids should not be used in patients with renal failure on
dialysis.
Sodium content may affect patients with hypertension, congestive heart failure,
or renal failure.
Adverse drug reactions (ADRs)
Magnesium-based antacids may cause diarrhea.
Aluminum- and calcium-based antacids may cause constipation.
Management of GI Discomfort
Click on each category below to explore its characteristics further.
ANTACIDS
Antacids neutralize acids in the gastrointestinal (GI) tract. Different combinations have
differing acid neutralizing capacities. Sodium bicarbonate and calcium carbonate have
the highest absolute neutrophil count (ANC).
Pharmacodynamics
Antacids neutralize gastric acid in the gastrointestinal (GI) tract. Causing an increased
pH in the stomach and the duodenal bulb. Antacids contain various combinations of
metallic cation.
Metallic cation + basic ion
Common metallic cation
Aluminum
Calcium
Magnesium
Basic anion
Hydroxide
Bicarbonate
Carbonate
Different combinations have differing acid neutralizing capacities.
Sodium bicarbonate and calcium carbonate have the highest absolute neutrophil
count (ANC).
Pharmacokinetics
Aluminum- and magnesium-based antacids are not absorbed with normal routine use.
Chronic use increases absorption by 5%-20%. Renally excreted. Calcium-containing
antacids require vitamin D for absorption. Excreted in feces
Clinical Uses:
Hyperacidity: antacids used for symptomatic relief of heartburn
May take four times per day (QID) or more
Discuss maximum dosages with patient
Peptic ulcer disease
May be used as adjunct to peptic ulcer disease (PUD) triple therapy treatment
, Used after meals and at bedtime
Gastroesophageal reflux disease (GERD)
Antacids are over-the-counter (OTC) and often-used first before patient seeks
care.
May be given every 30 to 60 minutes until symptoms subside
Maintenance after meals and bedtime
Histamine2 receptor antagonists or proton pump inhibitors (PPIs) are first-line
therapy.
Calcium deficiency
Chronic renal failure: 1,000 mg calcium
carbonate daily
Osteoporosis prevention
Men and premenopausal women: 1,000 mg daily
Postmenopausal women: 1,500 mg daily
Doses higher than 2,000 mg/day not recommended
Rational Drug Selection
Combination products have the highest ANC
Sodium content
Cost
OTC
Inexpensive, but may vary
Generics OK
Monitoring
Magnesium level in elderly patients who use magnesium-containing products
chronically
Precautions and contraindications
Abdominal pain of unknown cause
Calcium-based antacids contraindicated if patient is hypercalcemic or has renal
calculi.
Magnesium-based antacids are contraindicated in patients with renal failure or
renal insufficiency.
Aluminum-based antacids should not be used in patients with renal failure on
dialysis.
Sodium content may affect patients with hypertension, congestive heart failure,
or renal failure.
Adverse drug reactions (ADRs)
Magnesium-based antacids may cause diarrhea.
Aluminum- and calcium-based antacids may cause constipation.
