Action: Antacids are basic compounds that neutralize gastric acidity and decrease the rate of gastric emptying. Products are divided into those containing aluminum, magnesium, calcium, or a combination of these.

Uses: Hyperacidity is decreased by antacids in conditions such as peptic ulcer disease, reflux esophagitis, gastritis, and hiatal hernia.

Side effects / Adverse reactions: The most common side effect caused by aluminum-containing antacids is constipation, which may lead to fecal impaction and bowel obstruction. Diarrhea occurs often when magnesium products are given. Alkalosis may occur when systemic products are used. Constipation occurs most frequently than laxation with calcium carbonate. The release of CO2 from carbonate-containing antacids causes belching, abdominal distention, and flatulence. Sodium bicarbonate may act as a systemic antacid and produces systemic electrolyte disturbances and alkalosis. Calcium carbonate and Sodium bicarbonate may cause rebound hyperacidity and milk-alkali syndrome. Alkaluria may occur when products are used on a long-term basis, particularly in persons with abnormal renal function.

Contraindications: Sensitivity to aluminum or magnesium products may cause hypersensitive reactions. Check for sensitivity before administering.

Precautions: Magnesium products should be given cautiously to patients with renal insufficiency and during pregnancy and lactation. Sodium content of antacids may be significant; use with caution for patients with hypertension, CHF, or those on a low sodium diet.

Interactions: Drugs whose effects may be increased by some antacids: quinidine, amphetamines, pseudoephedrine, levodopa, valproic acid, dicumarol. Drugs whose effects may be decreased by some antacids: cimetadine, corticosteroids, ranitidine, iron salts, phenothiazines, phenytoin, digoxin, tetracyclines, ketoconazole, salicylates, isoniazid.

Possible nursing diagnoses:
» Pain [uses]
» Constipation [adverse reactions]
» Diarrhea [adverse reactions]

Nursing Considerations

» Aggravating and alleviating factors of epigastric pain or hyperacidity; identify the location, duration, and characteristics of epigastric pain
» GI symptoms, including constipation, diarrhea, abdominal pain; if severe abdominal pain with fever occurs, these drugs should not be given
» Renal symptoms, including increasing urinary PH, electrolytes

» All products with an 8oz glass of water to ensure absorption in the stomach
» Another antacid if constipation occurs with aluminum products

» The therapeutic effectiveness of the drug; absence of epigastric pain and decreased acidity should occur

Teach patient/family:
» Not to take other drugs within 1-2 hours of antacid administration, since antacids may impair absorption of other drugs

Selected Generic Names

Aluminum hydroxide
Bismuth subsalicylate
Calcium carbonate
Dihydroxyaluminum sodium carbonate
Magnesium oxide
Sodium bicarbonate

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