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Management of GI Discomfort Click on each category below to explore its characteristics further. ANTACIDS Antacids neutralize acids in the gastrointestinal (GI) tract. Different combinations have differing acid neutralizing capacities. Sodium bicarbonate and calcium carbonate have the highest absolute neutrophil count (ANC). Pharmacodynamics Antacids neutralize gastric acid in the gastrointestinal (GI) tract. Causing an increased pH in the stomach and the duodenal bulb. Antacids contain various combinations of metallic cation. • Metallic cation + basic ion • Common metallic cation • Aluminum • Calcium • Magnesium • Basic anion • Hydroxide • Bicarbonate • Carbonate • Different combinations have differing acid neutralizing capacities. • Sodium bicarbonate and calcium carbonate have the highest absolute neutrophil count (ANC). Pharmacokinetics Aluminum- and magnesium-based antacids are not absorbed with normal routine use. Chronic use increases absorption by 5%-20%. Renally excreted. Calcium-containing antacids require vitamin D for absorption. Excreted in feces Clinical Uses: • Hyperacidity: antacids used for symptomatic relief of heartburn • May take four times per day (QID) or more • Discuss maximum dosages with patient • Peptic ulcer disease • May be used as adjunct to peptic ulcer disease (PUD) triple therapy treatment • Used after meals and at bedtime • Gastroesophageal reflux disease (GERD) • Antacids are over-the-counter (OTC) and often-used first before patient seeks care. • May be given every 30 to 60 minutes until symptoms subside • Maintenance after meals and bedtime .......................................continued.............................................