2016 Treatments for Acid-Peptic Diseases

Buffer acid
ALUMINUM HYDROXIDE, CALCIUM CARBONATE, MAGNESIUM HYDROXIDE, SODIUM BICARBONATE


DRUG
ADVANTAGES
DISADVANTAGES
SERIOUS (but extremely rare)
SIDE EFFECTS
ALUMINUM
HYDROXIDE
  1. efficient
  2. low systemic absorption
  1. constipation
  2. not very effective when given alone
  1. phosphate absorption (forms aluminum phosphate precipitates) Ca2+ loss osteomalacia
MAGNESIUM
HYDROXIDE
  1. efficient
  2. low systemic absorption
  1. osmotic diarrhea
  1. renal insufficiency → hypermagnesemia → CNS & cardio-toxicity
CALCIUM
CARBONATE
  1. rapid onset of action
  2. long duration
  1. belching, gastric distension
  2. rebound acid secretion
  1. mild systemic alkalosis
  2. hypercalcemia in patients with impaired renal function if taken with dairy products (milk-alkali syndrome)
SODIUM
BICARBONATE
  1. extremely rapid onset of action
  1. belching, gastric distension
  2. short duration of action
  3. systemic absorption
  1. severe metabolic alkalosis
  2. alkalinizes urine
  3. hypercalcemia in patients with impaired renal function if taken with dairy products (milk-alkali syndrome)
  4. absorption of NaCl → fluid retention in patients with heart failure, hypertension or renal insufficiency

Milk -alkali syndrome is caused by excessive consumption of high calcium foods with certain antacids, over a long period of time. As there are now better agents for the long-term suppression of acid secretion (e.g., PPIs and H2 blockers), milk-alkali syndrome is more commonly observed in patients who are taking CALCIUM CARBONATE as a calcium supplement for the treatment of osteoporosis.

Early stages of the syndrome are asymptomatic. Calcium deposits accumulate in the tissues, and can cause kidney failure, which can be permanent.

Email: Dr. Janet Fitzakerley | ©2016 University of Minnesota Medical School Duluth Campus | Last modified: 7-jan-16 9:37 PM