DIFINITION

Mechanism of action
Therapeutic Indications of antacids
Criteria of ideal antacids
Side effects
Antacid mixtures
Interactions
Dosage form
DIFINITION:

acid neutralizing capacity (ANC)

They mainly include:

Aluminum hydroxide
Magnesium hydroxide

Magnesium carbonate
Sodium bicarbonate
 :Mechanism of action
They buffer gastric acid , raising the PH to reduce acidity in the.
. stomach
Other mechanisms may contribute, such as the effect of.
aluminum ions inhibiting smooth muscle cell contraction and
.delaying gastric emptying
N.B
The chemical antacids show the most rapid onset of action, but
may cause "acid rebound," a condition in which the gastric
acid returns in greater concentration after the drug effect has
stopped
: Therapeutic Indications of antacids
Antacids are taken by mouth to.1
relieve heartburn , the major
symptom of gastroesophageal
. reflux disease

Treatment with antacids.2

alone is symptomatic and only
.justified for minor symptoms
High doses can be effective in .3
promoting healing of duodenal
.ulcer ; 140mEq (7 timedaily)
The usefulness of antacids in peptic ulcer
: disease is due to
.reduction ( neutralization ) of peptic acidity.1
. inactivation of pepsin (inactive at PH{4) .2
stimulation of prostaglandin production (PGE2 & PGI2: increase mucus & HCO3 .3
.secretion , decrease acid secretion & increase mucosal blood flow )

. reduction of Helicobacter pylori colonization .4

:Criteria of ideal antacids
. cheap.1
.palatable .2
. rapid onset & long duration .3
. No systemic absorption to avoid disturbance of acid base balance .4
. No effect on bowel habit.5
. No drug interaction .6

.No CO2 release .7

:Side effects
Carbonate: alkalosis gastric distension
Calcium : increase calcium output in the urine
“,acid rebound"
Sodium :hypertension ,heart failure
Aluminum hydroxide : hypophosphatemia
.osteomalacia conistipation
Magnesium hydroxide :laxative hypermagnesemia
 Pregnancy and breastfeeding
:Antacid mixtures
there are no ideal antacids

sodium bicarbonate and MgO are efficient and

react quickly while Mg trisilicate and AL(OH)3
react slowly with a longer duration of action .
AL+3 ions tend to cause constipation while
. Mg+2 tend to cause laxation
Interactions
Dosage form

the liquid form is generally more effective . antacid

are better taken one hour after meal when the
buffering action of food ceased hence the effect
may last for 2_3 hs. While taken on empty
stomach, they are effective for 20-40 mins. Only
.because gastric emptying