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A Review on Pharmacology and Therapeutic Uses of Antacids

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A Review on Pharmacology and Therapeutic Uses of Antacids International Journal for Environmental Rehabilitation and Conservation ISSN: 0975 — 6272 XI (SP2): 114 — 119 www.essence-journal.com Review Article A review on pharmacology and therapeutic uses of Antacids Saraswat Renu1, Chatterji Nupur1 and Saraswat Devesh2 1Department of Chemistry, Meerut college, Meerut, India 2Department of chemistry, Eicher School, Faridabad, India Corresponding Author: [email protected]; [email protected] A R T I C L E I N F O Received: 20 July 2020 | Accepted: 15 August 2020 | Published Online: 30 September 2020 EOI: 10.11208/essence.20.11.SP2.136 Article is an Open Access Publication. This work is licensed under Attribution-Non Commercial 4.0 International (https://creativecommons.org/licenses/by/4.0/) ©The Authors (2020). Publishing Rights @ MANU—ICMANU and ESSENCE—IJERC. A B S T R A C T Antacids have been used since the last more than hundred years for the symptomatic relief by raising the pH of the stomach and without hampering the gastric condition of the body namely killing of bacteria. Sodium bicarbonate, aluminium hydroxide, magnesium hydroxide besides ranitidine and the prazoles react with the HCL present in the stomach and have become the ready choice of physicians to treat all kinds of gastric disorders. This study sheds a light on the pharmacokinetics of various antacids, their advantages, disadvantages and the chemical conditions which they help to subside. Present paper specifically focuses on the study of clinical uses and side effects of long run use of antacids K E Y W O R D S Antacids | Gastric pH | GERD | Ulcer C I T A T I O N Saraswat, Renu; Chatterji, Nupur and Saraswat, Devesh (2020): A review on pharmacology and therapeutic uses of Antacids. ESSENCE Int. J. Env. Rehab. Conserv. XI (SP2): 114 — 119. https://eoi.citefactor.org/10.11208/essence.20.11.SP2.136 114 ESSENCE—IJERC | Saraswat et. al., (2020) | XI (SP2): 114 — 119 Introduction antacids. They are usually the hydroxides of Drugs: The term drug is derived from the aluminium, magnesium,calcium or sodium french word "DROGUE" which means bicarbonate which are alkaline in nature and herbs. Natural products extracted from counteract the acid in the stomach to make plants, fungi, algae, sponges, animals and the pH more neutral. The normal gastric pH worms have been used for the treatment of range of the stomach is 1.5 to 3.5. diseases since time immemorial.A drug is a Antacids were used in the treatment of natural or synthetic substance which when gastric problems since a long time. They give administered affects the functioning and relief from the condition of hyperacidity and structure of a living body. These drugs can other gastrointestinal problems by neutrlizing be used for the diagnosis ,treatment or the gastric acid and thereby increasing the prevention of a disease and at the same time pH of gastric contents, balancing acid-base relieving of the discomfort. As a number of ratio, lowering the pepsin activity and raising herbs are being used since ancient times for bicarbonate and prostaglandin secretion. The the treatment of various ailments therefore antacids quickly relieve occasional heartburn compounds and herbs for treatment of which happens to be the major symptom of various diseases are known as drugs in gastroesophageal reflux disease (GERD). modern age also. They do not kill bacteria or inhibit other Drugs are the chemical compounds which actions of body and hence are distinct from are either synthesized in the laboratory or of the reducing drugs. plant animal or marine origin and intends to Gastroesophageal reflux (GERD) is a normal bring change in normal physiological physiological process short duration, often function of the body. Medicinal or remain asymptomatic, and limited to the therapeutic drugs are the substances or distal part of esophagus. According to the preparations which are used in the treatment American College of Gastroenterology of diseases. Thus in short we can say that all GERD is defined as the “mucosal damage medicines are essentially drugs but all drugs that produce chronic symptoms by the are not medicines. abnormal presence of gastric juices in the Monitoring of therapeutic drugs is a branch esophagus produced by hyperacidity”. of clinical chemistry and clinical Types of Antacids pharmacology that deals with the Drugs are classified mainly into two measurement of medication concentration in categories on the basis of digestive the blood. Drugs are basically chemicals absorption which affect the course of conditions, 1. Absorbable diseases, syndrome or pathology to benefit Sodium carbonate (baking soda) the health of an individual. Magnesium oxide (magnesia) Antacids and their medical uses Magnesium carbonates A common class of medicines that neutilize Calcium carbonates the acid presnt in the stomach, heartburn, Bourget mixture (sodium bicarbonates, indigestion and upset stomach are termed as sulphate, phosphate) 115 ESSENCE—IJERC | Saraswat et. al., (2020) | XI (SP2): 114 — 119 Rennie mixture (calcium carbonates, Magnesium hydroxide magnesium carbonates) Aluminum-magnesium combination Tums mixture (calcium carbonates, Aluminum-magnesium combination with magnesium oxide). other Active ingredients (anesthetics, antiflatulents, alginates, etc.) Table 1 2. Non-absorbable Aluminum phosphate Aluminum hydroxide Magnesium silicate S. No. Antacid Advantages disadvantages Clinical conditions 1. Calcium Potent and rapidly GI distress Heartburn Acid indigestion carbonate acting Nausea/vomiting Upset stomach Hypercalcemia Hypo- phosphatemia, milk-alkali syndrome 2 Magnesium Slow but prolonged Low solubility and Dyspepsia Heart burn trisilicate action laxative (at reactivity, Absorbed Hyperacidity Constipation larger doses) systemically (problem in renal compromised function patients) 3 Magnesium GI distress, Electrolyte Hyperacidity and peptic ulcer carbonate imbalances Hypotension dyspepsia heartburn GERD Neuromuscular blockade Constipation hypotension 4 Magnesium Reacts with HCl Low water solubility, no Constipation, digitalis toxicity hydroxide Promptly and is an systemic alkalosis (mg is Gastric acidity efficacious antacid, low poorly absorbed from gut) Hypomagnesaemia Peptic ulcer systemic absorption Pre-eclampsia, Magaldrate 5 Magaldrate Good oral antacid with Diarrhea Constipation Gastritis Hyperacidity Reflux prompt and sustained Intestinal pain esophagitis neutralizing action 6 Aluminium Raises the pH of the Efficient, low systemic Chronic diarrhea, hyper hydroxide gastric juice, Adsorbs absorption, Decreases parathyroidism pepsin phosphate excretion via Hyperphosphatemia (in renal kidney failure), nephrolithiasis, peptic ulcer, reflux esophagitis, stress ulcers 7 Sodium Most rapidly acting Metabolic alkalosis with Heartburn Alkalinisation of bicarbonate antacid urine alkalinisation, Intake urine Acidosis of large doses Table 1: Important Antacids and their features Conventional antacids offer less combination of simethicone and loperamide symptomatic relief from gastric problems (Imodium Advanced) and is effective in and therefore their use has been declined relieving abdominal bloating however, it has with the availability of more efficacious anti- not been studied in nondiarrhoea-associated acid secretory medications (H2 blockers and flatulence. PPIs). Pharmacokinetics An important type of antacid usually given Absorbable antacids are rapidly dissolving after the administration of Anaesthesia or to substances that immediately react with reduce post operational acidity is a hydrochloric acid in the stomach forming 116 ESSENCE—IJERC | Saraswat et. al., (2020) | XI (SP2): 114 — 119 carbon dioxide and water. Carbon dioxide units in the GERD pathogenesis. In case causes gastric distention which provokes of erosive GERD antacids are given as a gastroesophageal reflux and stimulates co-drug to the PPIs main course. gastric secretion enhancement. 2. Acute gastritis: In this case antacids are used in addition to proton pump Most of the antacids used are non adsorbable inhibitor therapy, H2-blockers in the but Sodium carbonate acts differently as it is treatment of acute gastritis especially absorbed into the blood affecting the with severe pain and dyspeptic organisms pH in whole. Patients with syndromes. They play an important role absolute renal failure excrete the excess of in the prevention and/or treatment of bicarbonate rapidly while some of this acid reflux. The presence of bile acids bicarbonate is accumulated causing systemic and lysolecithin(responsible for fat alkalosis in cases of patients with breakage)poses a hinderance in their parafunction of the kidneys. Most antacids action. used in medical practice are non-absorbable, 3. Chronic Gastritis / Gastroduodenitis: without systemic pharmacokinetics. To prevent recurrences, antacids are Indications and Principles of Сlinical Use either used alone or in combination with Clinical chemistry is the branch of chemistry antisecretory agents. These drugs that deals in the therapeutic management of supposed to be of choice for preventing drugs and specializes in the measurement of and treating eflux gastritis, where the the concentration of medicines in the blood main disturbing factor are found to be .High security Antacid are supposed to be bile acids and lysolecithin. the drugs of choice for the self treatment 4. Gastropathy caused by nonsteroidal because of the quick symptomatic effect, anti-inflammatory drugs (NSAIDs - pleasant organoleptic properties and, gastropathy): In order to prevent convenient presentation
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