Antacids

Antacids
Learn about the different antacids in this nursing pharmacology study

guide.
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.
Table of Contents
 Antacids: Generic and Brand Names
 Disease Spotlight: Ulcer Disease
 What are Antacids?
 Therapeutic actions
 Indication
 Pharmacokinetics
 Contraindications and Cautions
 Adverse effects
 Interactions
 Nursing considerations
 Nursing Assessment
 Nursing Diagnosis and Care Planning
 Nursing Implementation with Rationale
 Evaluation
Antacids: Generic and Brand Names
Here is a list of the most commonly encountered antacids and their
brand names.
 Antacids
 aluminum salts (AlternaGel)
 calcium salts (Oystercal, Tums)
 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 1-3 h
IV Immediate Rapid Unknown
Half-life (T1/2) Metabolism Excretion
unknown – 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.

Antacids

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Antacids

Learn about the different antacids in this nursing pharmacology study

 Ulcer patients present with a predictable description of gnawing,

 Neutralize stomach acid by direct chemical reaction.

 Symptomatic relief of GI hyperacidity, treatment of

Route Onset Peak Duration

Oral Rapid 30 min 1-3 h

IV Immediate Rapid Unknown

Half-life (T1/2) Metabolism Excretion

unknown – unchanged in urine

Contraindications and Cautions

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

 GI: Gastric rupture.

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

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

 Assess for possible contraindications and cautions: any history of

Nursing diagnoses related to drug therapy might include the following:

 Diarrhea related to GI effects.

The nursing interventions for patients using antacids are:

 Adequate drug absorption. Administer the drug apart from

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

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