Antacid constipation with

ANTACIDS. When antacids are given, the nurse keeps a record of the patient s bowel movements because these drug may cause constipation or diarrhea. If the patient experiences diarrhea, the nurse keeps an accurate record of fluid intake and output along with a description of the diarrhea stool. Changing to a different antacid usually alleviates the problem. Diarrhea may be controlled by combining a magnesium antacid with an antacid containing aluminum or calcium. 

A variety of adverse effects have been reported following the use of antacids. If sodium bicarbonate is absorbed, it can cause systemic alkalization and sodium overload. Calcium carbonate may induce hypercalcemia and a rebound increase in gastric secretion secondary to the elevation in circulating calcium levels. Magnesium hydroxide may produce osmotic diarrhea, and the excessive absorption of Mg++ in patients with renal failure may result in central nervous system toxicity. Aluminum hydroxide is associated with constipation serum phosphate levels also may become depressed because of phosphate binding within the gut. The use of antacids in general may interfere with the absorption of a number of antibiotics and other medications. 

For example, aspirin should be avoided in patients with ulceration and patients taking anticoagulation medications. It is possible that misuse or overdose of OTC products may develop into many medical problems. For example, improper use of antacids (e.g., aluminum hydroxide) causes constipation. 

Constipation can be associated with the use of opiates, such as morphine and codeine, calcium channel blocking agents, antacids containing aluminium compounds and iron salts used in the treatment of anaemia. 

Calcium carbonate is mainly used in oral pharmaceutical formulations and is generally regarded as a nontoxic material. However, calcium carbonate administered orally may cause constipation and flatulence. Consumption of large quantities (4—60g daily) may also result in hypercalcemia or renal impairment. Therapeutically, oral doses of up to about 1.5 g are employed as an antacid. In the treatment of hyperphosphatemia in patients with chronic renal failure, oral daily doses of 2.5-17 g have been used. Calcium carbonate may interfere with the absorption of other drugs from the gastrointestinal tract if administered concomitantly. 

Antacids neutralize gastric acid, inactivate pepsin, and bind bile salts. Aluminum-containing antacids also suppress HP and enhance mucosal defense. ° G1 adverse effects are most common with antacids and are dose dependent. Magnesium salts cause an osmotic diarrhea, whereas aluminum salts cause constipation. Diarrhea usually predominates with magnesium/aluminum preparations. Aluminum-containing antacids (except aluminum phosphate) form insoluble salts with dietary phosphorus and interfere with phosphorus absorption. Hypophosphatemia occurs most often in patients with low dietary phosphate intake (e.g., malnutrition or alcoholism). Combined treatment with sucralfate may amplify the hypophosphatemia and the potential for aluminum toxicity (see section on sucralfate). 

Magnesium hydroxide, an antacid with laxative properties (6 to 20 ml/p.o.), is used as an antacid, as a laxative in constipation, and in bowel evacuation before surgery. 

The most common side effect of sucralfate is constipation (-2%). some aluminum can be absorbed, sucralfate should be avoided in patients with renal failure who are at risk for aluminum overload. Likewise, aluminum-containing antacids should not be combined with sucralfate in these patients. Sucralfate forms a viscous layer in the stomach that may inhibit absorption of other drugs, including phenytoin, digoxin, cimetidine, ketoconazole, and fluoroquinolone antibiotics. 

Diarrhea, i renal function (result hypermagnesemia) maiabsorption syndrome. PO. Well absorbed, quickly excreted by kidney. II II Used with aluminum or calcium antacids to prevent constipation. 

Anticholinergics should be taken before meals to decrease the acid secretion that occurs with eating. They should not be taken with antacids because antacids can slow the absorption of antichloinergic administration. Side effects include dry mouth, decreased secretions, tachycardia, urinary retention, and constipation. However, because gastric emptying time is delayed, gastric secretions can be stimulated and actually aggravate the ulceration. 

Although small amounts of calcium carbonate are safe, regular use can cause constipation. Aluminum hydroxide, the active ingredient in Amphojel, can also cause constipation in large doses. Because calcium carbonate and aluminum hydroxide can cause constipation, antacids such as Maalox and My-lanta contain aluminum hydroxide mixed with magnesium hydroxide to counteract the constipating effects of the former with the laxative action of the latter. 

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