Antacids alginates

Antacid/alginic acid (Gaviscon) 2 tablets or 1 5 mL after meals and at bedtime AND/OR C. Patient-directed therapy Over-the-counter H2RAs (each taken up to twice daily) - Cimetidine 200 mg - Lamotidine 1 0 mg - Nizatidine 75 mg - Ranitidine 75 mg OR Over-the-counter PPI (taken once daily) - Omeprazole 20 mg agent. 

Antacids e.g., magnesium trisihcate or aluminium hydroxide or antacid-alginate combinations... 

Pheniramine Acetate (Naphcon A) Nepafenac (Nevanac) Olopatadine (Patanol) GASTROINTESTINAL Antacids Alginic Acid +... 

Sodium alginate forms a raft on the stomach contents leading to a reduction in reflux. Aluminium is an insoluble salt that is used as an antacid with no particular advantage in reflux. Chloroform water is a traditional preparation to reduce colic. Sucrose and lactose are sugars with no effect on gastro-oesophageal reflux disease. 

Alginic Acid + Aluminum Hydroxide Magnesium Tnsilicate (Gaviscon) [Antacid] [OTC] Uses Heartburn hiatal hernia pain Action Protective layer blocks gastric acid Dose 2—4- tabs or 15-30 mL PO qid followed by H2O Caution [B, -] Avoid in renal impair or Na -restricted diet Disp Tabs, susp SE D, constipation Interactions T Absorption OF tetracyclines EMS None OD May cause constipation, loss of appetite, muscle weakness, and peripheral edema symptomatic and supportive... 

Alginic acid may be combined with an antacid to encourage adherence of the mixture to the mucosa, e.g. for reflux oesophagitis. 

Antacids are helpful in controlling mild reflux symptoms when taken regularly after meals with additional doses as needed. Preparations in which an antacid is combined with alginate are particularly useful the alginate produces a viscous floating gel, which blocks reflux and protectively coats the oesophagus. 

Formulations that contain alginates can cause gastric bezoars, as can tube-feed thickening when antacids are added (11). 

Therapeutically, alginic acid has been used as an antacid. 

Stanciu C, Bennett JR. Alginate/antacid in the reduction of gastro-oesophageal reflux. Lancet 1974 i 109—111. 

Demulcents are agents or preparations that protect the mucous membranes and relieve pain and irritation. They are thought to work by forming a protective film and are commonly incorporated into antacid preparations for protecting the gastric mucosa of the mouth. The most commonly used is alginic add or one of its alginate salts. 

Graham DY, Lanza F, Dorsch ER. Symptomatic reflux esophagitis A double-blind controlled comparison of antacids and alginate. Curr Ther Res 1977 22 653-658. 

Radioactive strontium is its own biomarker of exposure in children and adults. The primary biomarkers of effect, also applicable to children and adults, are a reduction in lymphocyte and other blood cell counts, which closely match the intensity of exposure. The alginate method for reducing peak absorption, described above, has been validated for children (Sutton et al. 1971a). It is not clear whether another recommended treatment, a single dose of aluminum phosphate antacid gel, would be safe for children, since it can have toxic effects in children at high doses. Either method would only be effective if administered very soon after exposure (within an hour). 

The organoleptic characteristics, level of impurities, exchange capacities, pRa/ pH, affinity for inorganic ions, intrinsic viscosities, molecular weights, buffer capacity in artificial gastric fluids and other properties of 3 different types of alginic acids used in antacid preparations are discussed."... 

Strontium-90 Alginate or aluminum hydroxide-containing antacids may reduce intestinal absorption of strontium. Dose 10 g, then 1 g 4 times daily. Barium sulfate may also reduce Sr absorption. Dose 100 g in 250 mL water PO. Calcium gluconate may dilute the effect of strontium. Dose 2 g in 500 mL PO or IV. Ammonium chloride is a demineralizing agent. Dose 3 g PO 3 times daily. 

The absorption of cimetidine, famotidine, nizatidine, and ranitidine may possibiy be reduced to some extent by antacids, but it seems doubtful if this significantly reduces their effects. Separating the dosages by 1 to 2 hours minimises any interaction. Roxa-tidine absorption appears not to be affected by antacids. Cimetidine appears not to interfere with the effectiveness of Gaviscon (sodium alginate compound). 

Maalox does not appear to alter the pharmacokinetics of omeprazole, pantoprazole or rabeprazole. Antacids may cause a slight reduction in the bioavailability of lansoprazole. This is probably not clinically relevant but can be accommodated by separating their administration by one hour. There is no interaction between sodium alginate and omeprazole. 

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