Antacids sodium bicarbonate

SYMPATHOMIMETICS ANTACIDS-SODIUM BICARBONATE Possibly t ephedrine/ pseudoephedrine levels Alkalinising urine 1 excretion of these sympathomimetics Watch for early features of toxicity... 

Urinary alkalinizers (antacids, sodium bicarbonate, acetazolamide)... 

Table 14.2 lists some common bases. Sodium hydroxide and potassium hydroxide are found in most chemistry laboratories. They are also used in processing petroleum and cotton and in soap and plastic manufacturing. Sodium hydroxide is the active ingredient in products such as Drano that work to unclog drains. Sodium bicarbonate can be foimd in most homes as baking soda and is also an active ingredient in many antacids. When taken as an antacid, sodium bicarbonate neutralizes stomach acid (see Section 14.5), relieving heartburn and sour stomach. 

Sodium bicarbonate is a gastric antacid that may cause systemic alkalosis on overdose and may contribute to edema owing to sodium retention. It is useful for systemic acidosis because both deficient ions are present in the same molecule, and it can be used topically as a moist paste or in solution as an antipmritic. Sodium bicarbonate also is an ingredient of many effervescent mixtures, alkaline solutions, etc. One gram of NaHCO neutralizes 115 mL 0.1 NHCl. 

C. avoid antacids containing sodium bicarbonate or sodium carbonate... 

This electrolyte plays a vital role in the acid-base balance of the body. Bicarbonate may be given IV as sodium bicarbonate (NaHC03) in the treatment of metabolic acidosis, a state of imbalance that may be seen in diseases or situations such as severe shock, diabetic acidosis, severe diarrhea, extracorporeal circulation of blood, severe renal disease, and cardiac arrest. Oral sodium bicarbonate is used as a gastric and urinary alkalinizer. It may be used as a single drug or may be found as one of the ingredients in some antacid preparations. It is also useful in treating severe diarrhea accompanied by bicarbonate loss. 

Sodium bicarbonate is used as a leavening in breads, as a stomach antacid, as a buffering agent to adjust the acidity or alkalinity of a product, as a mild abrasive in toothpaste, and as an odor absorber. Sodium bicarbonate reacts with acids to release carbon dioxide gas. 

Each Alka-Seltzer tablet contains 1916 mg of sodium bicarbonate, 1000 mg of citric acid (Fig. 9.1.2), and 325 mg of aspirin or acetylsalicylic acid (Fig. 9.1.3). Bromo Seltzer also contains sodium bicarbonate and citric acid as well as acetaminophen (Fig. 9.1.4). Several equilibria describe the action of bicarbonate-based antacid tablets. First of all, sodium bicarbonate dissolves completely in aqueous solution to generate sodium ions and bicarbonate ions ... 

Inorganic compounds such as aluminium hydroxide, sodium bicarbonate, and magnesium and calcium carbonates are commonly used as antacids. There is much scope for the redesign of these agents to achieve fine control of local pH values in the gastrointestinal tract via control of the rate of release of the active bases (e.g., from insoluble compounds). 

Sodium carbonate (Na CO ) is the eleventh most used industrial chemical in the United States. It is commonly used as a bleaching agent and is manufactured in a two-step process. First, ammonia is combined with carbon dioxide to form sodium chloride and water, which reacts to form sodium bicarbonate and ammonium chloride (NH + CO + NaCl + H O —> NaHCOj + NH Cl). Sodium bicarbonate, commonly known as baking soda, is used as a leavening agent in baking, as an antacid to relieve stomach acid, and as a component for fire extinguishers. The second step is known as the Solvay process, wherein the sodium bicarbonate is heated and converted into sodium carbonate (NaHCO A— Na CO + H O + CO ). 

Milk-alkali syndrome Milk-alkali syndrome, an acute illness with symptoms of headache, nausea, irritability, and weakness, or a chronic illness with alkalosis, hypercalcemia and, possibly, renal impairment, has occurred following the concurrent use of high-dose calcium carbonate and sodium bicarbonate. Hypophosphatemia Prolonged use of aluminum-containing antacids may result in hypophosphatemia in normophosphatemic patients if phosphate intake is not adequate. 

Concomitant therapy - Absorpt on is impaired by antacids containing aluminum, calcium, or magnesium, and preparations containing iron, zinc, or sodium bicarbonate. 

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. 

Patients with CHFor HTN should avoid taking antacids with sodium bicarbonate Monitoring Parameters... 

The reactions in Table 13.8 show that carbon dioxide is a common product in many neutralization reactions. This is clearly displayed when a drop of vinegar (acetic acid) is added to baking soda (sodium bicarbonate). Some aspirin includes an antacid in their formulation to neutralize some of the acidity imparted by the aspirin (acetylsalicylic acid). These are commonly referred to as buffered aspirins. 

Alkali antacids are very effective at neutralising acid rapidly, but as described above, particulate antacids—especially aluminium salts, can cause pulmonary inflammation, and are no longer widely used. Non-particulate antacids, sodium citrate or bicarbonate, have not been shown to cause damage, and are used in conjunction with H2 blockers. They will neutralise acid already in the stomach, although pocketing of the stomach contents may prevent mixing with and neutralisation of all the contents. 

Sodium Bicarbonate [NaH0O3] [Antacid/Alkalinizing Agent1]... 

Five principal active ingredients are used in antacid preparations (1) Sodium bicarbonate isa rapid and effective neutralizer. The compound does yield large amounts of absorbable sodium, undesirable in some... 

FIGURE 27-1 T Neutralization of hydrochloric acid [HCI] by the primary forms of antacids. In each reaction, the antacid combines with HCI to form a salt and water. Carbon dioxide [C02] is also produced by calcium carbonate and sodium bicarbonate antacids. 

The primary antacids can be classified as aluminum-containing, magnesium-containing, calcium carbonate-containing, sodium bicarbonate-containing, or a combination of any of these classifications. These drugs are typically taken orally, either as tablets or as a liquid oral suspension. 

Tetracyclines, as broad-spectrum antibiotics, are the drugs of choice in treating Mycoplasma pneumoniae infections. Most tetracyclines are absorbed to various degrees (30 to 100%) from the gastrointestinal tract, primarily from the stomach and upper small intestine. The absorption of tetracyclines is hindered by milk and milk products, by numerous antacids such as aluminum hydroxide, sodium bicarbonate, and calcium carbonate, and by iron preparations such as ferrous sulfate. Therefore, these and similar substances should not be administered orally together with tetracycline (Figure 3.4). 

Because acid-pepsin disease rarely occurs in the absence of gastric acid and pepsin, antacids are highly effective in its overall management. Antacids consist of a mixture of magnesium, aluminum, and calcium compounds. Their efficacy is based on their inherent ability to react with and neutralize gastric acid. Sodium bicarbonate, which may leave the stomach rapidly, can cause alkalosis and sodium retention. Calcium salts may produce hypercalcemia, which can be detrimental in patients with impaired renal function. Aluminum salts may decrease the absorption of tetracyclines and anticholinergic drugs. 

Calcium carbonate(eg, Turns, Os-Cal) is less soluble and reacts more slowly than sodium bicarbonate with HC1 to form carbon dioxide and CaCl2. Like sodium bicarbonate, calcium carbonate may cause belching or metabolic alkalosis. Calcium carbonate is used for a number of other indications apart from its antacid properties (see Chapter 42 Agents That Affect Bone Mineral Homeostasis). Excessive doses of either sodium bicarbonate or calcium carbonate with calcium-containing dairy products can lead to hypercalcemia, renal insufficiency, and metabolic alkalosis (milk-alkali syndrome). 

Sodium bicarbonate is widely used in the food industry, in making rubber in pharmaceuticals as an antacid in fire extinguishers, soap and detergents, rug cleaners, animal feeds, and textiles in leather preparation in soap, detergent, and paper manufacturing for flue-gas scrubbing and for many other diversified small-scale uses. 

Silicon may be present in various forms in some preparations, e.g. as tri-silicate in antacids, polydimethyl-siloxane or silicone oil (see also section VII, ref. 77). The sample may be evaporated to dryness and the residue fused with sodium bicarbonate or another fusion agent, or taken up in hydrofluoric acid provided strong heating and loss of silicon is avoided. A nitrous oxide/acetylene flame must be used. Chromium may be found in disinfectants and antiseptics. Unless dilution of the sample is possible the use of the injection-cup technique (see section II.A) may be preferable as otherwise large amounts of corrosive salts such as sodium hypochlorite will be aspirated. If iron is also present it may be necessary to use a nitrous oxide/ acetylene flame. Arsenic in arsenamide and lead arsenate preparations can be determined by boiling the sample in 5% nitric acid and aspiration of the sample [111]. Better sensitivity would be obtained using hydride generation (see section II.A). 

Antacids. See the relevant sections for the interactions of antacids. Antacids such as aluminium-, magnesium- and calcium-containing antacids and sodium bicarbonate reduce the absorption of iron and also of drugs that require an acidic pH in the stomach for their optimal uptake. 

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