Antacid adverse effects

Adverse effects with the tetracyclines include gastrointestinal upset drug interactions with dairy products, antacids, and iron and phototoxicity. Minocycline can also cause vestibular complications (headache and dizziness) and skin discoloration that is not typical with tetracycline and doxycycline.16... 

The answer is d. (Katzung, pp 1064-1066J Although A1 hydroxide is generally considered to be the antacid that inhibits phosphate absorption, Ca carbonate is equally capable of this effect. This adverse effect may be hazardous in the presence of renal impairment. 

GI complaints are the most common adverse effects of NSAIDs. Minor complaints such as nausea, dyspepsia, anorexia, abdominal pain, flatulence, and diarrhea occur in 10% to 60% of patients. NSAIDs should be taken with food or milk, except for enteric-coated products (milk or antacids may destroy the enteric coating and cause increased GI symptoms in some patients). 

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. 

When levodopa is given without a peripheral decarboxylase inhibitor, anorexia and nausea and vomiting occur in about 80% of patients. These adverse effects can be minimized by taking the drug in divided doses, with or immediately after meals, and by increasing the total daily dose very slowly antacids taken 30-60 minutes before levodopa may also be beneficial. The vomiting has been attributed to stimulation of the chemoreceptor trigger zone located in the brain stem but outside the blood-brain barrier. Fortunately, tolerance to this emetic effect develops in many patients. Antiemetics such as phenothiazines should be avoided because they reduce the antiparkinsonism effects of levodopa and may exacerbate the disease. 

Dicyclomine (Bentyl) [Anrimuscarinic, GI Anrispasmodic/ Anticholinergic] Uses Functional IBS Action Smooth-muscle relaxant Dose Adults. 20 mg PO qid T to 160 mg/d max or 20 mg EM q6h, 80 mg/d - qid then T to 160 mg/d, max 2 wk Feds. Infants >6 mo 5mg/dose tid-qid Children 10 mg/dose tid-qid Caution [B, -] Contra Infants <6 mo, NAG, MyG, severe UC, BOO Disp Caps, tabs, syrup, inj SE Anticholinergic SEs may limit dose Interactions T Anticholinergic effects W/ anticholinergics, antihistamines, amantadine, MAOIs, TCAs, phenothiazides T effects OF atenolol, digoxin X effects H7 antacids X effects OF haloperidol, ketoconazole, levodopa, phenothiazines EMS Avoid procainamide usage, may T adverse effects may T effects of digoxin, monitor... 

Action HMG-CoA reductase inhibitor Dose 5-40 mg PO daily max 5 mg/d w/cyclosporine, 10 mg/d w/gemfibrozil or CrCl <30 mL/rain (avoid Al-/Mg-based antacids for 2 h after) Caution [X, /-] Contra Active liver Dz, unexplained T LFT Disp Tabs SE Myalgia, constipation, asthenia, abd pain, N, myopathy, rarely rhabdomyolysis Interactions T Effects OF warfarin T risk of myopathy W/ cyclosporine, fibrates, niacin, statins EMS T Effects of warfarin concurrent EtOH use can T risk of liver tox Asian pts have an T risk of adverse effects OD Unlikely to cause life-threatening Sxs... 

Calcium has long been implicated as a dietary factor which inhibits the absorption of manganese. Since manganese is better absorbed in the oxidized (+2) than in the reduced state (+3 or +4), any factor which increases gastrointestinal tract pH (increases alkalinity) would be expected to inhibit manganese utilization. Calcium carbonate, a commonly used antacid by humans as well as a calcium nutrient supplement, has been found to have a greater adverse effect on apparent manganese absorption in humans than does milk. 

Antacids are basic substances that reduce gastric acidity by neutralising HCl. The hydroxide is the most common base but trisilicate, carbonate and bicarbonate are also used. Therapeutic efficacy and adverse effects depend also on the metallic ion with which the base is combined, and this is usually aluminium, magnesium or sodium. Calcium and... 

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