Week 5: Nutrition: Acid-Controlling Drugs- either prevent, neutralize, or control the
secretion of acid in the stomach. These drugs also affect how medications are absorbed.
Where Acid-Controlling Drugs Work- Acid controlling drugs either block substances needed
to stimulate the parietal cell, or they neutralize excess acid that has bee secreted.
Examples of acid-controlling drugs:
• Antacids: calcium or magnesium containing antacids- work by neutralizing acid in the
stomach
• Histamine 2 Antagonist: ranitidine, famotidine, -block histamine receptors,
Inhibits gastric acid secretion for up to 12 hours by blocking receptors on
parietal cells.
• Proton pump inhibitor: pantoprazole, omeprazole - prevent ATP pump from working
within the parietal cell
Acid-Controlling Medication Indications and Uses- Most common usage is to treat the
symptoms of gastroesophageal reflux. They are also commonly used to prevent stress-related
ulcer in hospitalized pts. It is not unusual for a proton pump inhibitor like pantoprazole to be
given to clients in ICU even though they may not have history of reflux. The meds may also be
used in clients who take meds that are hard on the stomach, like non-steroidal anti-
inflammatories. Acid reducing meds are used in conjunction with antibiotics to treat clients with
gastritis related to bacterial infection.
The major medications are:
• Antacids
• Histamine 2 (H2) Blockers (H2 receptor antagonist)
• Proton Pump Inhibitors
• Miscellaneous Acid-Controlling Drugs
Antacids: work by raising stomach pH and neutralizing stomach acid. This change in pH and
acid content provides relief from hyperacidity (heartburn) symptoms. In those with
inflammation and ulceration of the stomach lining, antacids reduce the acid as an irritant,
allowing time for the stomach lining to heal.
Various Antacids
Aluminum, magnesium, calcium, and sodium are salt compounds found in over-the-counter
antacid preparations.
Drug Interactions- antacids alter the pH of the stomach, impacting how other drugs are
metabolized, absorbed, and/or excreted. There are four ways that antacids affect other
medications:
• Adsorption – Reduces the ability of the other drug to be adsorbed in the body
• Chelation – Chemically inactivates other drugs producing insoluble complexes
• Stomach pH – Increases the absorption of basic drugs and decreases the absorption
of acidic drugs
• Urinary pH – Increases the excretion of acidic drugs and decreases the excretion of
basic drugs
, *Care should be taken to administer antacids two hours before or one hour after daily meds.*
Antacid Contraindications and Cautions
Salt Compound Contraindications Nursing Considerations
Magnesium-Containing Renal disease Use cautiously in clients with renal disease.
Antacids Carbonate
Salt
Aluminum-Containing Abdominal pain, Use cautiously in clients with hypercalcemia or
Antacids Carbonate no bowel sounds hypophosphatemia.
Salt
Calcium-Containing No bowel sounds, High amounts of calcium carbonate can cause milk-alkali
Antacids Carbonate renal stones, syndrome, which is associated with hypercalcemia.
Salt hypercalcemia
Sodium-Containing Hypernatremia Metabolic alkalosis may occur if sodium bicarbonate is
Antacids overused over a long period of time.
Bicarbonate Salt
Antacids are sometimes combined to prevent side effects from each salt compound.
Understanding Side Effects- common side effects of antacids:
• Magnesium carbonate – This antacid can cause diarrhea. In fact, magnesium is used in
laxative products just for its osmotic effect. Magnesium hydroxide antacids can cause
hypermagnesemia in clients with chronic renal failure.
• Aluminum hydroxide – This antacid can cause constipation by inhibiting the
contraction of smooth muscle. In some cases, magnesium is mixed with aluminum as
a combined antacid to reduce this side effect.
• Calcium carbonate – This antacid can cause constipation and other side effects. By
increasing calcium levels in the body, this antacid can increase the risk of kidney
stones. Chronic calcium carbonate use can lead to milk-alkali syndrome, which is
characterized by headache, nausea, alkalosis, and hypercalcemia.
• Sodium bicarbonate – This antacid mixes with stomach acid to produce carbon
dioxide gas. This causes a belching reaction when administered. Sometimes
simethicone, a gas- reducing substance, is added to this antacid to treat the excessive
gas. Concerns about metabolic alkalosis in a client taking too much sodium bicarbonate
antacid.
H2 Receptor Antagonists- these meds work on one component of the acid producing cycle to
reduce acid secretion in the stomach. Reduce acidity in stomach by blocking receptors on gastric
parietal cells in the stomach. Used in the treatment of GERD, ulcers, and relieve symptoms of
hyperacidity.
MOA: blocks the H2 receptor of acid-producing parietal cellsreduces hydrogen ion (acid),
secretion from the parietal cells, increases the pH of the stomach
Drug Names- H2 receptor antagonist medication generic names end in -tidine. Examples of
these medications are
secretion of acid in the stomach. These drugs also affect how medications are absorbed.
Where Acid-Controlling Drugs Work- Acid controlling drugs either block substances needed
to stimulate the parietal cell, or they neutralize excess acid that has bee secreted.
Examples of acid-controlling drugs:
• Antacids: calcium or magnesium containing antacids- work by neutralizing acid in the
stomach
• Histamine 2 Antagonist: ranitidine, famotidine, -block histamine receptors,
Inhibits gastric acid secretion for up to 12 hours by blocking receptors on
parietal cells.
• Proton pump inhibitor: pantoprazole, omeprazole - prevent ATP pump from working
within the parietal cell
Acid-Controlling Medication Indications and Uses- Most common usage is to treat the
symptoms of gastroesophageal reflux. They are also commonly used to prevent stress-related
ulcer in hospitalized pts. It is not unusual for a proton pump inhibitor like pantoprazole to be
given to clients in ICU even though they may not have history of reflux. The meds may also be
used in clients who take meds that are hard on the stomach, like non-steroidal anti-
inflammatories. Acid reducing meds are used in conjunction with antibiotics to treat clients with
gastritis related to bacterial infection.
The major medications are:
• Antacids
• Histamine 2 (H2) Blockers (H2 receptor antagonist)
• Proton Pump Inhibitors
• Miscellaneous Acid-Controlling Drugs
Antacids: work by raising stomach pH and neutralizing stomach acid. This change in pH and
acid content provides relief from hyperacidity (heartburn) symptoms. In those with
inflammation and ulceration of the stomach lining, antacids reduce the acid as an irritant,
allowing time for the stomach lining to heal.
Various Antacids
Aluminum, magnesium, calcium, and sodium are salt compounds found in over-the-counter
antacid preparations.
Drug Interactions- antacids alter the pH of the stomach, impacting how other drugs are
metabolized, absorbed, and/or excreted. There are four ways that antacids affect other
medications:
• Adsorption – Reduces the ability of the other drug to be adsorbed in the body
• Chelation – Chemically inactivates other drugs producing insoluble complexes
• Stomach pH – Increases the absorption of basic drugs and decreases the absorption
of acidic drugs
• Urinary pH – Increases the excretion of acidic drugs and decreases the excretion of
basic drugs
, *Care should be taken to administer antacids two hours before or one hour after daily meds.*
Antacid Contraindications and Cautions
Salt Compound Contraindications Nursing Considerations
Magnesium-Containing Renal disease Use cautiously in clients with renal disease.
Antacids Carbonate
Salt
Aluminum-Containing Abdominal pain, Use cautiously in clients with hypercalcemia or
Antacids Carbonate no bowel sounds hypophosphatemia.
Salt
Calcium-Containing No bowel sounds, High amounts of calcium carbonate can cause milk-alkali
Antacids Carbonate renal stones, syndrome, which is associated with hypercalcemia.
Salt hypercalcemia
Sodium-Containing Hypernatremia Metabolic alkalosis may occur if sodium bicarbonate is
Antacids overused over a long period of time.
Bicarbonate Salt
Antacids are sometimes combined to prevent side effects from each salt compound.
Understanding Side Effects- common side effects of antacids:
• Magnesium carbonate – This antacid can cause diarrhea. In fact, magnesium is used in
laxative products just for its osmotic effect. Magnesium hydroxide antacids can cause
hypermagnesemia in clients with chronic renal failure.
• Aluminum hydroxide – This antacid can cause constipation by inhibiting the
contraction of smooth muscle. In some cases, magnesium is mixed with aluminum as
a combined antacid to reduce this side effect.
• Calcium carbonate – This antacid can cause constipation and other side effects. By
increasing calcium levels in the body, this antacid can increase the risk of kidney
stones. Chronic calcium carbonate use can lead to milk-alkali syndrome, which is
characterized by headache, nausea, alkalosis, and hypercalcemia.
• Sodium bicarbonate – This antacid mixes with stomach acid to produce carbon
dioxide gas. This causes a belching reaction when administered. Sometimes
simethicone, a gas- reducing substance, is added to this antacid to treat the excessive
gas. Concerns about metabolic alkalosis in a client taking too much sodium bicarbonate
antacid.
H2 Receptor Antagonists- these meds work on one component of the acid producing cycle to
reduce acid secretion in the stomach. Reduce acidity in stomach by blocking receptors on gastric
parietal cells in the stomach. Used in the treatment of GERD, ulcers, and relieve symptoms of
hyperacidity.
MOA: blocks the H2 receptor of acid-producing parietal cellsreduces hydrogen ion (acid),
secretion from the parietal cells, increases the pH of the stomach
Drug Names- H2 receptor antagonist medication generic names end in -tidine. Examples of
these medications are
