Recommended by antacid drugs is referred to. Antacids - action, species and features of use

Prior to the appearance of a group of H 2-histimane receptor blockers, antacids were the first line of the therapy of ulcerative disease. Today, these without prescription drugs for eliminating heartburn is distinguished by low cost, availability, high efficiency and good tolerance by most patients.

However, antacids do not just reduce the acidity of gastric content: the neutralization of the pH has another effect? Reducing the proteolytic activity of pepsin enzyme, which is active in an acidic medium and is able to aggressively affect the gastric mucosa and cause esophagitis. In addition, in the pathogenesis of the development of esophagitis, bile acids can also be involved, which can throw in the cavity of the stomach. Antacids based on aluminum, calcium and magnesium compounds are capable of adsorbing and removing bile acids; At the same time, the results of a number of studies have shown that calcium / magnesium and aluminum-containing antacids are most actively adsorbed on themselves just more part of lipophilic and toxic bile acids (Torres VE, Velosa JA, Holley Ke et al., 1991; H Nsel W., Herzog T., 1998). Thus, antacids provide rational treatment and effective relief of the state of most patients with gastroesophageal reflux disease, while without having to access the means of system action.

It is hardly worth stopping on whether the mechanism of the action of drugs, saving us from acidic belching and heartburn. We all also know the classification of antacids, which subdivides them in composition (drugs of magnesium, aluminum preparations, calcium preparations and combinations of aluminum, calcium and / or magnesium preparations), as well as absorbable and unsuitable.

Antacids: Terra Incognita?

However, despite the long-term experience and, it would seem, the comprehensive study of antacids, do we really know everything about this group of medicines? This is especially true of the security profile of these drugs. Moreover, it should be borne in mind that the majority of patients in the appearance of gastrointestinal disorders do not apply to the doctor, but it is precisely non-receptible drugs. According to a survey of 500 Russian patients who experienced heartburn, a sense of gravity and overflow in the stomach, as well as pain in the epigastric area, only 44% of them previously appealed to the doctor. To relieve symptoms, 78% of respondents independently accepted antacids (Moiseev S.V., 2006). The continuing the popularity of antacids is confirmed and the growing volumes of pharmacy sales of drugs of this group.

All this prompted us to explore the antacid market, the features of their effectiveness and security.

Aluminum-containing antacids

As noted above, aluminum compounds are one of the components of antacid drugs. The ingredient is most used in such antacids are aluminum hydroxide; Among other widely used aluminum compounds? Aluminum oxide, aluminum hydroxide hydroxide, aluminum phosphate, dihydroxyaluminine sodium carbonate, aluminum acetoacetate, aloglotamol, aluminum glycinate.

Aluminum is contained not only in many antacid means, but is generally widely distributed in the environment, we often face it in everyday life. It? one of the most common elements of the earth's crust; Is it a metal that is used in a wide variety of industries? From aircraft construction to simple jackets from under beverages and kitchen foil. And yet, despite the greater prevalence, this element does not perform any important biological functions, in contrast to other metals, such as iron or copper. The daily rate of aluminum consumption is negligible. However, taking aluminum-containing antacids, the patient can consume a day to several grams of aluminum.

The use of aluminum in the composition of antacids has a long history and refers to the 1920s, when it was believed that in our body the absorption of this element does not comply. However, the results obtained not so long ago indicate the opposite? Aluminum can adsorb. So, the use of some beverages, such as wine, orange juice, coffee or soda, against the background of the use of antacids containing aluminum compounds, increases the receipt of this element several times. When receiving antacids based on aluminum compounds in high doses or with enviable regularity, this element is gradually accumulated in bone tissue and brain tissues, which leads to fragility of bones and neurological disorders characterized by disorder of memory and speech functions (Lauwerys RR, Hoet P., 2001; Friesen MS, Purssell Ra, Gair RD, 2006).

In addition, it should be remembered that the main side effect of antacids based on aluminum salts is constipation. This, in particular, it is important to take into account for patients who make up a risk group, such as pregnant, patients receiving opiates, as well as elderly patients with limited fluid consumption or dehydration.

Aluminum-containing antacids: treat care!

However, aluminum can harm not only those who directly take drugs containing this metal, but also to future generations, many scientists believes.

Heartburn quite often accompanies such a state as pregnancy. That is why pregnant women are often forced to take antacid funds with regularity; Thus, the pregnancy is a typical example when antacids can be applied regularly and for a long time, especially considering the fact that over the pregnancy of heartburn tends to exacerbation. At the same time, animal experiences testify that aluminum penetrates the placenta and accumulates in the fetus tissues, causing various disorders of development, including death in utero., vices, slow-comphected skeleton, growth delay, etc. (Bennet R., Persaud T., Moore K., 1975; Domingo J., Gomez M., Colomina M., 2000). The possibility of intoxicating aluminum during its oral use is largely depends on the bioavailability of the drug used and the presence of other substances in the food, which increase the absorption of aluminum. These facts are essential from a practical point of view. On the one hand, the frequency of heartburn associated with the gastroesophageal reflux, pregnant women reach 85%, and approximately 30-50% of them enjoy antacids (BrousSard C., Riechter J., 1998). On the other hand, the fruit and the newborn may be more sensitive to the toxic effects of aluminum. The case of developing a heavy neurodegenerative disease in the girl, whose mother took antacids during pregnancy at extremely high doses (up to 15 g of aluminum per day) (Gibert-Barnes E., Barness L., Wolff J. et al., 1998). Of course, this example cannot be extrapolated to normal practice, but it is worthwhile to take into account the fact that the developing fetus may be significant and significantly smaller doses of aluminum.

Some researchers found aluminum in breast milk in women, which indicates the possibility of entering it into the organism of newborn in breastfeeding (Mandic M., GRGIC J., GRGIC Z. et al., 1995).

In many European countries there are certain restrictions on the use of aluminum-containing antacids in pregnant and nursing women. For example, in Austria, France, Italy, Spain and Switzerland in liner sheets, it is indicated that it is necessary to use antacids containing aluminum during pregnancy and breastfeeding follows only on the recommendation of the doctor or pharmacist (Maton P., Burto V., 1999).

The most complete information on the possible unwanted effects of aluminum-containing antacids is presented in the instructions for use and promotional materials in Germany. Thus, it clearly indicates that the simultaneous use of these drugs with drinks containing acids, such as fruit juice or wine, leads to an undesirable enhancement of aluminum absorption in the intestine, and to avoid intoxicating aluminum in a child, during pregnancy the drug can only be taken during pregnancy. A short time is also particularly noted that aluminum compounds penetrate breast milk (Maton P., Burto V., 1999).

Continuation of the story about antacid

preparations? In the nearest rooms

"Pharmacy Weekly"

Antacid drugs (antacids) - a group of drugs whose action is aimed at oppression of manifestations of dyspeptic disorders provoked by the increased acidity of the stomach. Antacids are neutralized by excess hydrochloric acid, reducing the intensity of the manifestation of symptoms and facilitating the patient's condition.

For normal digestion in the stomach, hydrochloric acid is produced - it helps to activate a number of enzymes and destroy pathogenic bacteria that fall into the gastrointestinal tract. The organ itself, to protect against the aggressive effect of hydrochloric acid, is covered with a thick mucous membrane. If it is violated its integrity, erosions are beginning to appear on the inner surface of the stomach, which over time can lead to peptic ulcer. In some cases, it is possible to weaken the lower esophageal sphincter, which leads to the enzymes in the esophagus, causing its irritation and inflammation.

The active components of antacids in aqueous solution have alkaline properties, and therefore the excess of hydrochloric acid is neutralized. This reduces the aggressive impact of the gastric juice, which is manifested by a decrease in heartburn. Modern drugs not only neutralize the stomach medium, but also envelop the walls of the organ, which contributes to a more rapid restoration of the mucous membrane.

Indications for use

Antacids are appointed in the following cases:

Attention! Antacid tools can be used both once and course. Prolonged reception of such drugs must be coordinated with the doctor to avoid the manifestations of side effects.

Varieties of antacids

All antacids group drugs are divided into two large categories.

1. Suction. This group of drugs contains substances that are capable of absorbed into the systemic blood flow through the gastric wall. They are distinguished by the rapid manifestation of the therapeutic effect. At the same time, during neutralization, a large amount of carbon dioxide occurs in the patient in the stomach. This leads to the appearance of belching, meteorism, reflux. The total proportion of suction active substances can be up to ⅕ on the total number of active substances. Therefore, the reception of the absorbing antacids is better to do it, in order to avoid strong violations of the electrolyte balance.
2. Nepsasyavy. More popular group of drugs. They differ in prolonged action, but the effect of their application comes later than from the reception of suction funds. It is helpful not only to neutralize the acidic wedge of the stomach, but also envelop its walls, protecting them and contributing to a faster recovery. It is non-sembling antacids for a long admission, since they are less affecting the work of other bodies and systems. The exceptions are patients with renal failure, since a part of the aluminum is excreted through the kidneys, which falls into the bloodstream.

Attention! The reception of suction antacids can lead to the effect of the "acid rickest" - when, at the end of the preparation, the stomach begins to more intensively synthesize hydrochloric acid. Such an effect occurs as a result of too quickly leaning the medium of the stomach, which causes the compensatory effect. For this reason, the absorbable antacids are not recommended for the reception at night when food cannot soften the effects of hydrochloric acid on the stomach.

According to the actors, such groups of antacid drugs are distinguished:

Medicinal forms

Antacid drugs are available in several dosage forms:

Such dosage forms begin to act immediately - they are not protected by a shell, and therefore their dissolution begins after entering the stomach environment. Suspensions are more convenient for home use, while tablets are more convenient to use outside the house. When chewing and resorbing tablets, the start of exposure time is reduced and the relief of heartburn comes faster.

Rules for acceptance and validity

Antacid tools are accepted to eliminate heartburn and dyspeptic phenomena. For the prevention of such disorders, drugs are accepted by a course, the duration of which is established individually.

The effect of receiving suction funds is manifested immediately, and in disadvantaged - after 10-15 minutes. The expiration date of non-quasive drugs lasts up to 4-5 hours. The effect of the use of suction funds lasts 1.5-2 hours.

Contraindications and side effects

There are practically no special contraindications to the use of antacid drugs. It is impossible to receive the means of this group with increased sensitivity to active ingredients and with renal failure. A number of drugs are prohibited for use in childhood up to 3 years, during pregnancy and lactation.

The main side effects from use can be attributed:

The above side effects arise quite rarely and, in most cases, when violating instructions for use.

Overview of popular antacid drugs

Now there are no obsistent antacids. The reason for that softer action and the absence of the effect of an "acid ricochet" after application.

If the therapy with the use of antacids does not bring due effect, and the patient's condition continues to deteriorate, you need to contact the gastroenterologist. Special attention deserves the manifestation of such symptoms:

Antacid reception is carried out three times a day, after eating food, and before bedtime. When combining this group of funds with other drugs, it is recommended to pause between taking at least 2 hours in order not to influence the intensity of the absorption of the active components of other drugs.

Video - Antacid: what it is

Among the drugs that affect the digestive system, the antacid group is less common. The reason for this is the presence of other medicines that suppress acidoproduction. However, antacid drugs can also be applied, although noticeably less. In view of the safety, especially inherent in non-nursing antacids, their use is also expanding due to the contingent of pregnant women. In general, these are safe medicines that have clinical disadvantages, but there are objective advantages.

Because of the most important disadvantage, that is, the phenomenon of "ricochet", antacid drugs are noticeably less common in the treatment of esophageal, gastric and intestinal diseases. The essence of the "ricochet" is reduced to a compensatory increase in the amount of acid extracted by parietal gastral cells in response to its antacid neutralization. At first, the level of the gastric pH increases, but then acidity will increase (the pH will decrease even more than before). This limits the capabilities of antacids in disorders of acid formation.

The place of antacids in the pharmacological classification

The group of drugs affecting the secretory abilities of the stomach includes many substances, including the drugs of an antacid group. All gastrotropic drugs are divided by two types of use. The first is the means that compensate for the lack of secretion of the stomach contain enzymes and artificial gastric juice, as well as substances used in excess secretion. The latter include disadvantaged and suction antacids.

Insecursive constitute the bulk of the antacids, since they do not have a systemic effect. They do not violate blood pH and safely when using children and pregnant women. However, during lactation, they are not used irrational, since the lack of undesirable effects is not proven. Although theoretically, since they do not fall into the blood and cannot penetrate into breast milk, you can justify their safety and lactation.

Classification of antacids

All antacid drugs are divided into two heterogeneous groups: suction and disadvantaged substances. Their mechanisms of action are different because of this. At the number of suction include:

• sodium bicarbonate is the simplest antacid with a rapid effect, but the prone to form a foam in the stomach;
• magnesium oxide is a safer substance, but the prone to cause hypermagniasis;
• calcium carbonate (it is safer than magnesium oxide, although it is inclined to cause hypercalcemia);
• the main (alkaline) calcium carbonate is weaker, because it is safer compared to the previous one;
• the main (alkaline) magnesium carbonate is safer than magnesium oxide, and the same efficiency with alkaline calcium carbonate;
• bourge mixture (composition of sodium bicarbonate, sulfate and phosphate);
• mixtures of calcium and magnesium carbonates.

All specified antacid drugs are the names of the substances from which they consist. Only in the latter case, the mixture of antacid substances is the product name of the drug. This is Renny, "Andrews Antacid" and "Tams". However, in terms of efficiency, all the absorbable approximately the same, and the effect of reducing acidity they provide quickly. However, due to the violations of the blood plasma electrolyte profile, they are less safe than their unusable class analogs.

Non-surging antacids

These include insoluble magnesium compounds, calcium and aluminum, which, after flowing a chemical reaction with hydrochloric acid, do not form gas and not absorbed into the blood. These are more advanced antacid drugs, the list of which is represented as follows (according to the ATX code):

• A02AA - magnesium-based preparations;
• A02ab - based on aluminum and its insoluble salts;
• A02AC - calcium antacids;
• A02AD - antacids of combined composition comprising salts and complex compounds of aluminum, magnesium, calcium and silicates.

The most common now is aluminum-magnesium or aluminum-magnesium-calcium antacid drugs. This is explained by many positive effects from combination. Side effects are also mutually neutralized: the cells of magnesium are diarrhea, and in aluminum derivatives - constipation. Modern antacids are combined with spasmolitics.

Therapeutic groups of non-surging antacid drugs

The composition of insoluble antacids determines their therapeutic properties. Depending on this, the type of medication suitable for the treatment of a certain disease is selected. The composition of antacids may be like this:

• aluminum phosphates (Phosfalugel);
• algecedrat with magnesium hydroxide ("Almathel", "Palmagel", "Altacid", "Gastracide", "Alumag", "Malukol", "Maaloks");
• sodium-calcium combinations, aluminum-magnesium-silicate antacid drugs with alginate ("Gaviscon", "Topalkan");
• siemeticone in combination with aluminum-magnesium preparations (Almathel Neo, "Gesty", "Relzer").

Phosphalugel does not oversee the contents of the stomach and intestines and is most active at high acidity. What it is higher, the more important the therapeutic use of phosphhalugel. The second category of drugs is most often used in the treatment of ulcers and hyperacid gastritis. They are safe and efficient, although at very low pH values \u200b\u200bit is better to use aluminum phosphates.

The third category of drugs has an important feature: alginates prevent the cast of acidic content in the esophagus. By eliminating gastroesophaginal reflux, they effectively help in the treatment of GERD. On the one hand, these drugs neutralize acidity, and on the other, they protect the mucosa of the esophagus in its lower third of the aggressive impact of gastric content. All antacid preparations presented (examples) containing alginates are effective drugs for GERD.

Almagel Neo, "Relzer" or "Gestid" differ from the predecessors slightly. They are more like a second antacids group, that is, on a combination of insoluble salts of aluminum and magnesium. However, due to the presence of a "Simeticon" winder means, they eliminate meteorism. This effect is important from a clinical point of view for the reason that gases stretch the stomach and intestines, forcing the cells to produce acid. There is such a deficiency in the absorbing antacids, which he provokes the phenomenon of the Ricochet.

Other effects of antacids

Analyzing the substances on the basis of which antacid drugs were developed, their list of effects should be expanded. Their action is reduced not only to lower acidity due to chlorine binding, but also to protect the cells of the stomach mucosa. Such an effect is called gastrocytoprotection. It is maximally expressed in aluminum-containing antacids. Aluminum phosphate potentiates the speed of the synthesis of prostaglandins, due to which the frequency of cell divisions in the stomach increases. Also this substance is able to bind bile acids if they fall into the stomach.

In the intestine binding of bile acids is less important. In this way, the pathogen effect on the epithelium is thus reduced, which makes it possible to prevent the development of chronic gastritis like "C". It is due to the cast of bile in the stomach. But in the intestine, binding of bile acids leads to constipation. For this reason, aluminum-containing antacid drugs, the list of which is indicated above, must be combined with magnesium-containing. As can be seen, antacids are capable not only to neutralize the acid of the stomach, but also adjust the peristaltics of the intestinal tract and the recovery of the epithelium.

Indications

If you analyze antacid drugs, a list of their therapeutic and side effects, as well as the features of the composition and pharmacological action, one can determine the indications for their use. They depend on the specific type of antacid and a certain disease, as well as related states. Diseases requiring antacids are as follows:

• GERB (gastroesophaginal reflux disease);
• any diseases provoking GERB (Cardia Ahalasia, hernia of the esophageal aperture of the diaphragm);
• treatment of states after chemical or thermal burns of the esophagus;
• stomach ulcer;
• erosive gastropathy;
• duodenogastral reflux disease;
• paint ulcer.

All the above antacid drugs (list) are unsuitable for monotherapy of any of the listed diseases. The most competent treatment is their combination with means that reduce the secretion of hydrochloric acid. Preparations of the first row are they. These are L2 histamine receptor blockers and proton pump inhibitors. However, if necessary, antacid and antisecretory preparations are effectively combined, accelerating healing of ulcers and erosions.

Selection of antacids

Some antacid drugs whose names are indicated above should be considered as a means of choice for some pathologies. In particular, with GERD, it is rational to use combinations of aluminum-magnesium-silicate antacids with alginate. This is "Almatyel", "Palmagel", Altacid, Gastracide, Alumag, Maalukol, Maalox and other analogs in composition.

In case of chronic hyperacid gastritis of the type "C", as with any hyperacid states, it is reasonable to give the choice of Phosphalugel. It is also preferred with duodenogastral reflux. In other clinical situations, the choice depends on the accompanying states of the person. If it often occurs constipation, then preferably the purpose of magnesium antacids. In children it is better to apply aluminum magnesium drugs.

With the ulcer of the stomach and (or) of the 12rred intestine, any non-oxidic antacid drugs are used. The list of them is wide due to the presence of many commodity items. Often, initially one antacid with an anesthetic effect should be taken, and then use another substance without it. Anesthetic antacid is "Almagel A", which contains anesthesin (benzocaine). It must be taken 3-4 days if ulcers or erosion are accompanied by strong pains, and then replace to another antacid, without an analgesic substance. Without control of the doctor, it is allowed to take antacids no more than 14 days.

The use of antacids during pregnancy

All non-seated antacid drugs during pregnancy are safe, because they cannot be absorbed into the blood. The impossibility of providing a resorbative effect and provides this property. Therefore, in any period of pregnancy, antacid drugs, not suction in blood, can not harm neither the organism of the mother nor the fetus. The exception is a group of suction antacids, which theoretically cause harm due to disorders of electrolyte and acid-base equilibrium. Until the danger of the use of suction antacids during pregnancy is not excluded, from their use should be refused.

During lactation, the safety of the use of antacids remains uncertain. Tests with nursing women were not carried out, it means there is a chance to have unproved harmful effects. This risk is high in the absorbing antacids and theoretically, there must be absent from the universal. However, due to the lack of research information, as well as due to the lack of clinically significant experiments, to assign any antacid to a woman during lactation is contraindicated.

Application in pediatrics

In accordance with the legislative norms of the Russian Federation, the country is forbidden to give the proton pump inhibitors with young children. In this regard, in the occurrence of diseases of the stomach or 12-rosewoman, it is necessary to use antacids or H2 Blockers H2 histamine receptors. The impossibility of suction and the provision of a resorbative effect makes children's safe antacid drugs. They do not harm, do not damage the gastrointestinal tract, although they have some side effects.

Nevertheless, in pediatric practice, children's antacid drugs cannot be used widely, because there are only a small number of diseases that require their destination. In adult patients, on the contrary, the testimony is significantly more. Children are significantly less frequently incidents of the stomach, erosion, the diseases of the 12th-rosewoman. In addition, the use of aluminum-magnesium or exclusively aluminum disadvantaged antacids threatens constipation.

It is noteworthy that there are no suction antacid drugs for children. The reason for this is the risk of displacement of the electrolyte and acid-base balance. In children, normal concentrations change in smaller limits, because of which the risks of harm to the child with hypercalcemia, hypermagniasia or alkalosis is significantly higher than in an adult. Effective preparations in this case should be considered non-supersonic antacids that do not have sodium bicarbonates: "Almagel", "Alumag", "Maalox". "Phospholyugel" is not recommended to be applied due to the possibility of constipation.

Restrictions on the use of antacids

Antacid drugs, the classification of which indicates the presence of two types of drugs of the group, are somewhat limited to the application. This is due to pharmacokinetic and pharmacodynamic features, disorders of food suction and other medicines, as well as an infallible acid-based action. A short-term effect requiring frequent antacid use is also an important limitation of its application.

The duration of the acid-based action of non-surging antacids is 2-3 hours. Therefore, it becomes necessary to use them 4-6 times a day, which is inconvenient in practical terms. At the same time, in the case of the stomach ulcers or hyperacid gastritis, antacid means are capable of maintaining pH at 3-4. Without the use of drugs, the pH level is 1-1.5, which is characterized as a severe acidic medium.

A short-term reduction in acidity up to 3-4 units does not have an important therapeutic effect. And about 2 hours from the time of use, the pH values \u200b\u200bare restored. It means that the damaging factor provoking the emergence of chronic inflammation, erosion or ulcers, continues to operate. This characterizes antacids as defective and unsuccessful preparations for monotherapy of esophageal and gastric diseases.

Because of the pharmacological features described above, antacids gave way to the treatment of gastrointestinal diseases of histamine receptor blockers. The latter are less effective than modern proton pump inhibitors. Therefore, most often in the treatment of hyperacid states, ulcers and erosion preference is given to them. Examples of drugs are: "omeprazole", "Ezomeprazole", "Pantoprazole", "Lanzoprazole". They are moved well, have the minimum number of clinically significant side effects.

An objective place of antacid drugs

Evaluating the pharmacodynamic and pharmacokinetic features of the antacids, it is possible to make an obvious conclusion about the possible spheres of anticidal drugs. It is obvious that their effects are not enough for monotherapy of ulcers, erosive gastropathy, GERB. Therefore, only a few areas of clinical use remain only for non-surging antacids:

All antacid drugs (names are indicated above) are used mainly on an empty stomach, that is, 1 hour before meals or 2 hours after the last meal. They must be taken 4-6 times a day due to a short acid-based action. H + PAP or H2-receptors of histamine are used 1 time per day. Provided that antacids violate the absorption of other, more active drugs, they should not be used before taking proton pump inhibitors.

Also, antacids violate the absorption of antibiotics, can bind them and reduce their antibacterial activity in the treatment of helicobacter infection. In the case of the use of other drugs, it should be expected that against the background of the reception of non-seated antacids, the resorption of the remaining drugs is disturbed. Their therapeutic value drops significantly. Therefore, many clinicians recommend abandoning the appointment of antacid drugs if the level of plasma concentration of other drugs is of paramount importance.

Antacid drugs are a group of medicinal substances that neutralize the acid produced by the stomach of man. There are many trade names of the antacids that are supplied to the market in the form of tablets and suspensions.

When can I use antacid drugs?

Most often, antacid drugs are used to alleviate the patient of the pain in the chest and heartburn - the symptoms of reflux-esophagitis, the disease in which the caustic content of the stomach falls into the esophagus and causes inflammation of its mucous membrane. Also, antacid drugs can reduce the intensity of painful sensations at ulcer of the stomach and duodenal ulcers. They also apply when it is necessary to temporarily neutralize gastric acid, for example, with functional dyspepsia.

For a long time, antacid drugs are massively used to treat diseases of the digestive system. However, after the appearance of more modern drugs, such as proton pump inhibitors and H2 receptor blockers, it seemed that the era of antacids would go to the past. Modern medications are more efficient - they reduce the volume of acid produced by the stomach, while antacid drugs simply neutralize the acidic medium in the stomach for a short period of time.

Nevertheless, antacids have its own niche in modern medicine. The strong side of the antacid drugs is the speed of actions and, accordingly, the upcoming therapeutic effect. And, in contrast to the proton pump inhibitors and H2 receptor blockers, antacid drugs are generally cheaper.

How do antacids work?

To digest food and kill the pathoral bacteria that fell with it, the human stomach produces an acid. Gastric juice is so caustic that the inner surface of the stomach is equipped with a natural mucous membrane, which protects the surface of the organ from the effects of acids and the occurrence of erosion.

Under the influence of various factors, this barrier in some people may be damaged, which allows acid to start the inner surface of the stomach, which ultimately leads to an ulcer. In other cases, the annular muscle separating the stomach from the esophagus can relax, as a result of which the caustic content of the stomach penetrates into the esophagus and eventually causes inflammation of its mucous membrane (reflux-esophagitis).

Antacid drugs can neutralize acid, because chemicals contained in them are grounds (alkalis), the direct opposite of acids. The reaction between acid and the base is called neutralization. Thanks to this chemical reaction, gastric juice becomes less aggressive, which makes it easy to make pain from the ulcers, reduce the unpleasant sensations in the stomach and esophagus and heartburn.

What types of antacids exist?

The main active substances in antacid preparations are calcium, magnesium and aluminum compounds. According to the method of assimilation, antacids are divided into absorbable and non-supersonal.

The absorbable differences differ from non-unsolved antacids by themselves, or the products caused by them chemical reactions are absorbed by the intestinal walls and dissolve in the blood. Therefore, these drugs act very quickly, however, the number of complications increased compared to non-unsupported antacids makes their use undesirable. Suctional antacids include a conventional food soda (folk treatment of heartburn), drugs based on calcium and magnesium carbonate, etc.

Insecual antacids are more popular. Unlike the previous group, they begin to act slower, but the effect of their use is longer. The active substances of these drugs are aluminum and magnesium hydroxides, aluminum phosphate, sometimes in combination with each other. If aluminum compounds envelop a damaged surface with a protective film, magnesium compounds help the stomach to restore their own mucous barrier. In Russia, unsuppical antacid drugs are sold under the names of Almagel, Phosfaleugel, Maalox, "Gastal", etc.

Some trademarks of antacids contain a mixture of the main active substance with another drug, which helps or reduce the likelihood of side effects, or to help with the treatment of any disease.

For example, Almathel Neo and other drugs contain a simethicone, a substance that helps to reduce sometimes emerging with an antacid meteorism. The consequence of the neutralization reaction is the extraction of carbon dioxide, which causes the abdomen and flatulence. Antacid drugs, one of the components of which is Siemetikon, allow you to destroy the resulting carbon dioxide bubbles or to withdraw them naturally.

Some other drugs, along with antacids, includes alginia acid and its salts, alginates. The purpose of alginate additives is the protection of the inner surface of the esophagus from gastric acids. Usually, sodium alginate and alginic acid are used from alginates in medicine. When entering the stomach, these substances form a gel that, as it were, flooding over the contents of the stomach, interfering with it to fall into the esophagus and thereby injure its mucous membrane. These drugs are used in the treatment of reflux-esophagitis. One example of such antacids is "Gevisson".

In some cases, an analgesic for removing painful sensations is added to the antacid drug. One of these drugs is "Almagel A".

Do you need a recipe when buying antacids?

For some drugs, the recipe is needed for others - no.

What medicinal forms exist from antacid drugs?

Antacids are supplied to the pharmaceutical market in the form of tablets and suspensions. The latter can be sold both in the form of a large bottle and small bags, each of which contains a single dose of the drug. Suspensions are more beneficial from the point of view of the digestibility of the drug, but at work or during traveling is uncomfortable. Therefore, many people prefer to use suspensions at home, and tablets - when they come out. By the way, the tablets are absorbed faster if they can dear or dissolve.

How to take antacids?

As a rule, an antacid agent is taken to remove the symptoms or prevent their appearance. Before adopting antacid drugs, it is recommended to consult a doctor, as well as carefully examine the instructions attached to the medicine.

How fast are antacid funds begin to act? How long should the antacid drugs be taken?

Austal antacids begin to act almost instantly, non-quasive - after 9-15 minutes.

Antacids are usually prescribed for situational treatment - patients should take them only when symptoms appear and stop after their disappearance. However, some antacids, especially with additives, can be used for longer treatment or in combination with proton pump inhibitors, for example, to minimize harm from the recent night acid breakthrough (when during sleep for not detected by reasons of the stomach begins to produce acid ).

Who can not take antacids?

The list of contraindications depends on the specific drug and is specified on the instructions contained in the package.

Can side effects be observed when receiving antacids?

In some people, the use of antacids can contribute to the development of side effects. The most common of them: diarrhea, constipation and belching. A complete list of all side effects for each specific antacid can be viewed on the instructions supplied with the medicine.

The side effects of suction antacids are included. Acid ricochet - when the body responds to a sharp change in the medium in the stomach with sour to alkaline enhanced acid production. The intake of absorbing antacids can stimulate the formation of carbon dioxide, which increases the volume of the stomach, stretches its walls and can provoke the appearance of gastroesophageal reflux. If the absorbing antacid contains calcium, then its long-term application is fraught with constipation, nausea and vomiting. More calcium-containing antacids can in patients with urolithiasis cause increased formation of kidney stones.

Antacids should be avoided simultaneously with other drugs, because antacids can affect the degree of digestibility of other medications.

Additional Information

If the reception of antacids does not bring the desired relief and, on the contrary, it becomes worse, it is necessary to consult a doctor - perhaps a serious disorder of the digestive system began. Special attention should be paid to the following symptoms:

• Vomiting with blood. Blood can be both fresh and already rolled. In the latter case, the spewed masses look like a coffee thickness - dark and grainy consistency.
• Blood in feces. It happens both fresh and dark, curled, and stains the feces in black.
• Weight loss if the patient is not on a diet.
• Difficulty when swallowing, jammed food in the esophagus.
• Pain in stomach, nausea or vomiting for a long time.

In the therapeutic practice, doctors are often prescribed by antacid drugs. These medicines have the ability to reduce the acidity of the medium. The most common means were obtained in the treatment of diseases of the digestive organs (hyperacid gastritis, gastroesophageal reflux disease). What are the indications, contraindications and what is the mechanism of action of these drugs?

Antacids are drugs that are used in acid-dependent diseases.This medication group is known for a very long time. The first antacids began to be used in medicine more than 100 years ago. Medicines from this group have the following features:

• able to neutralize hydrochloric acid, normalizing pH;
• have a cytoprotective effect, protecting cells from aggressive influence of acids;
• capable of sorbitize bile acids;
• possess an enveloping effect.

In most cases, antacid drugs are an addition to the main treatment. These are medications symptomatic therapy. In contrast to other drugs that adjust the acidity, antacids have a faster and pronounced effect. The therapeutic effect is achieved due to the presence of magnesium, aluminum or calcium compounds.

Classification of antacid drugs

The list of antacids applied today is very wide. 2 large antacids groups are distinguished: non-supersonic and suction. The second group includes funds such as food soda, burned magnesia, magnesium carbonate, "Renny", "Tamm", calcium carbonate.

Representatives of this group have a quick effect, but it is short. In the process of neutralization, the acid is released by carbon dioxide, which often leads to the blown of the abdomen (meteorism) and belching. Suctional antacids are not used to treat gastroesophageal reflux disease. The possible side effect of these drugs is the phenomenon of the ricochet, in which the secondary increase in acidity occurs.

The most effective are non-compatible antacid drugs. This group includes phosphhalugel, "Almagel", "Maaloks", "Topalkan", "Gastracide", "Gevison". There are antacts that combine the main active ingredient with the auxiliary components. Most of the unsyassed antacids are combined. They are poorly absorbed in the gastrointestinal tract.

These medicines neutralize hydrochloric acid and pepsin, envelop the stomach mucosa, protecting it from the effects of hydrochloric acid, suppress the activity of the bacteria of the chielicobacter pylori.

The therapeutic effect lasts up to 4 hours. Neutralization begins a few minutes after taking medication. It is possible to be treated with antacid drugs in outpatient conditions.

They need to be taken 1-1.5 hours after meals. Most often, treatment implies a drug to 4 times a day. Antacid drugs are not desirable to use simultaneously with other medicines.

Indications and Contraindications for use

Antacids are accepted inward in the form of gels, suspensions or tablets. This group of drugs is used for the following pathological conditions:

• dyspepsia;
• gastroesophageal reflux;
• ulcerative gastric disease during the period of exacerbation;
• ulcerative duel of duodenal intestine during the period of exacerbation;
• duodenit;
• enterite;
• hernia of the esophageal hole of the diaphragm;
• inflammation of the mucosa of the esophagus against the background of the gastric reflux;
• functional intestinal disorders;
• discomfort in the epigastric area after drinking alcohol.

Antacids can be used with a prophylactic goal for preventing the inflammation of the stomach against the background of the use of drugs from the NSAID group. "Almagel A" can be included in the complex diabetes treatment regimen. Suction drugs are practically not applied. Antacids are well transferred, nevertheless there are some restrictions in their application.

Such an antacid as "Alzhel" is contraindicated in Alzheimer's disease, disorders of the excretory function of the kidneys and individual intolerance. The drug is not appointed for children under 1 month. "Gevisson" can not be taken to persons who have increased sensitivity to the main components of the medicine.

Antacid preparation "Maaloks" can not be used in the following states:

• severe renal failure;
• hypophosphatemi;
• shortage of sucrose;
• fructose intolerance.

Maalox is suitable only for persons over 15 years old. Contraindications for the reception of "phosphhalugel" are individual intolerance and renal failure.

Possible unwanted reactions

When compliance with the treatment regimen appointed by the doctor, side effects when receiving antacids occur very rarely. They are possible with uncontrolled drug use. Magnesium-based antacides may cause diarrhea. In case of overdose, it is possible to violate the kidney function and the impact of heart rate. Aluminum-based antacid agents can provoke hypophosphatem. If the medications are accepted in the presence of renal failure, it is possible to develop encephalopathy and softening bones. With prolonged use of magnesium-based drugs against the background of urolithiasis, the state of patients and strengthening the formation of stones may deteriorate.

These are common unwanted effects. Reception "phosphhalugel" in rare cases can lead to a constation. Most often it is observed in the elderly. When using "Gevucon", the development of allergic reactions is possible.

The reception of Maalox in rare cases can cause nausea, vomiting, stool disorders and taste sensitivity. Thus, non-psychic antacids are most effective. They are widely used to treat adults and children, in which acidity is broken.