Antacids: Antacids Are Used To Chemically React With and Neutralize The Acid in The Stomach. They Can

Antacids
Antacids are used to chemically react with and neutralize the acid in the stomach. They can
provide rapid relief from increased acid levels. They are known to cause GI alterations such
as diarrhea or constipation and can alter the absorption of many drugs.
Antacids: Generic and Brand Names
Here is a list of the most commonly encountered antacids and their brand names.
Classification Generic name Brand name
aluminum salts AlternaGEL
calcium salts Oystercal, Tums
Antacids magaldrate Losopan, Riopan
magnesium salts Milk of Magnesia, others
sodium bicarbonate Bell-ans
Disease Spotlight: Ulcer Disease
Erosions in the lining of the stomach and adjacent areas of the GI tract are called peptic
ulcer.
 Ulcer patients present with a predictable description of gnawing,

burning pain often occurring a few hours after meals.
 Many of the drugs that are used to affect GI secretions are designed to prevent,
treat, or aid in the healing of these ulcers.
 Further research led many to believe that, because acid production was often
normal in ulcer patients, ulcers were caused by a defect in the mucous lining that
coats the inner lumen of the stomach to protect it from acid and digestive enzymes.
 Treatment was aimed at improving the balance between the acid produced and the
mucous layer that protects the stomach lining.
What are antacids?
Antacids are a group of inorganic chemicals that neutralize stomach acid.
 Antacids are available OTC, and many patients use them to self-treat a variety of
GI symptoms.
 The choice of an antacid depends on adverse effects and absorption factors.
Therapeutic actions
The desired actions of antacids include the following:
 Neutralize stomach acid by direct chemical reaction.

Symptomatic relief of an upset stomach associated with hyperacidity, as well as the
hyperacidity associated with peptic ulcer, gastritis, peptic esophagitis, gastric hyperacidity,
and hiatal hernia.
Indication
Antacids are indicated for the following:
 Symptomatic relief of GI hyperacidity, treatment of hyperphosphatemia,

prevention of formation of phosphate urinary stones.
 Treatment of calcium deficiency, prevention of hypocalcemia.
 Prophylaxis of stress ulcers, relief of constipation.
Pharmacokinetics
Many of these antacids are available in combination forms to take advantage of the acid-
neutralizing effect and block adverse effects.
Route Onset Peak Duration
Oral Rapid 30 min 1-3h
IV Immediate Rapid Unknown
T 1/2: Unknown
Excretion: Unchanged in urine
Contraindications and Cautions
The following are contraindications and cautions when using antacids:
 Allergy. The antacids are contraindicated in the presence of any known allergy to

antacid products or any component of the drug to prevent hypersensitivity
reactions.
 Co-morbidities. Caution should be used in the following instances: any condition
that can be exacerbated by electrolyte or acid-based imbalance to prevent
exacerbations and serious adverse effects; any electrolyte imbalance , which could
be exacerbated by the electrolyte-changing effects of these drugs; GI obstruction
which could cause systemic absorption of the drugs and increase adverse effects;
renal dysfunction, which could lead to electrolyte disturbance if any absorbed
antacid is neutralized properly.
 Pregnancy and lactation. Antacids are contraindicated for pregnant and lactating
women because of the potential for adverse effects on the fetus or neonate.
Adverse effects
Adverse effects when using antacids include:
 GI: Gastric rupture.
 Systemic alkalosis: headache, nausea, irritability, weakness, tetany, confusion.
 Misc: Hypokalemia.
Interactions
Antacids can greatly affect the absorption of drugs from the GI tract.
 Alkalinity. Most drugs are prepared for an acidic environment, and an alkaline

environment can prevent them from being broken down for absorption or can
actually neutralize them so that they cannot be absorbed.
Nursing considerations
Nursing considerations for a patient using antacids include the following:
Nursing Assessment
History taking and physical exam in a patient using antacids include:
 Assess for possible contraindications and cautions: any history of allergy to

antacids to prevent hypersensitivity reactions; renal dysfunction, which might
interfere with the drug’s excretion; electrolyte disturbances, which could be
exacerbated by effects of the drug; and current status of pregnancy or lactation due
to possible effects on the fetus or newborn.
 Perform a physical examination to establish baseline data before beginning
therapy, determine the effectiveness of the therapy, and evaluate for any potential
adverse effects associated with the drug.
 Inspect the abdomen; auscultate bowel sounds to ensure GI motility.
 Assess mucous membrane status to evaluate potential problems with absorption
and hydration.
 Monitor laboratory test results, including serum electrolyte levels and renal
function tests, to monitor for adverse effects of the drug and potential alterations in
excretion that may necessitate dose adjustment.
Nursing Diagnosis and Care Planning
Nursing diagnoses related to drug therapy might include the following:
 Diarrhea related to GI effects.
 Risk for constipation related to GI effects.
 Imbalanced nutrition: less than body requirements related to GI effects.
 Risk for imbalanced fluid volume related to systemic effects.
 Deficient knowledge regarding drug therapy.
Nursing Implementation with Rationale
The nursing interventions for patients using antacids are:
 Adequate drug absorption. Administer the drug apart from any other oral
medications approximately 1 hour before or 2 hours after to ensure adequate
absorption of the other medications.
 Ensure therapeutic levels. Have the patient chew tablets thoroughly and follow
with water to ensure that therapeutic levels reach the stomach to decrease acidity.
 Perform diagnostic testing. Obtain specimens for periodic monitoring of
serum electrolytes to evaluate drug effects.
 Prevent imbalances. Assess the patient for any signs of acid-base or electrolyte
imbalance to ensure early detection and prompt interventions.
 Institute a bowel program. Monitor the patient for diarrhea or constipation to
institute a bowel program before severe effects occur.
 Ensure adequate nutritional status. Monitor the patient’s nutritional status if
diarrhea is severe or constipation leads to decreased food intake to ensure adequate
fluid and nutritional intake to promote healing and GI stability.
 Provide patient support. Offer support and encouragement to help the patient
cope with the disease and the drug regimen.
 Educate the patient. Provide thorough patient teaching, including the drug name
and prescribed dose, schedule for administration, signs and symptoms of adverse
effects and measures to prevent or minimize them, warning signs that may indicate
possible problems and the need to notify the health care provider immediately.
Evaluation
Evaluation of a patient using antacids include:
 Monitor patient response to the drug (relief of GI symptoms caused by

hyperacidity).
 Monitor for adverse effects (GI effects, imbalances in serum electrolytes, and acid-
base status).
 Evaluate the effectiveness of the teaching plan (patient can name the drug and
dosage, as well as describe the adverse effects to watch for, specific measures to
avoid them, and measures to take to increase the effectiveness of the drug).
 Monitor the effectiveness of comfort measures and compliance with the regimen.

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Antacids

Antacids: Generic and Brand Names

Classification Generic name Brand name

aluminum salts AlternaGEL

calcium salts Oystercal, Tums

Antacids magaldrate Losopan, Riopan

magnesium salts Milk of Magnesia, others

sodium bicarbonate Bell-ans

Disease Spotlight: Ulcer Disease

 Ulcer patients present with a predictable description of gnawing,

What are antacids?

Antacids are a group of inorganic chemicals that neutralize stomach acid.

The desired actions of antacids include the following:

 Neutralize stomach acid by direct chemical reaction.

Antacids are indicated for the following:

 Symptomatic relief of GI hyperacidity, treatment of hyperphosphatemia,

Route Onset Peak Duration

Oral Rapid 30 min 1-3h

IV Immediate Rapid Unknown

Excretion: Unchanged in urine

Contraindications and Cautions

The following are contraindications and cautions when using antacids:

 Allergy. The antacids are contraindicated in the presence of any known allergy to

Adverse effects when using antacids include:

 Alkalinity. Most drugs are prepared for an acidic environment, and an alkaline

Nursing considerations for a patient using antacids include the following:

History taking and physical exam in a patient using antacids include:

 Assess for possible contraindications and cautions: any history of allergy to

Nursing Diagnosis and Care Planning

Nursing diagnoses related to drug therapy might include the following:

Nursing Implementation with Rationale

The nursing interventions for patients using antacids are:

Evaluation of a patient using antacids include:

 Monitor patient response to the drug (relief of GI symptoms caused by

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