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At least 397 records · Page 22Linked to original sources
PubMed1987

Sucralfate suspension versus titrated antacid for the prevention of acute stress-related gastrointestinal hemorrhage in critically ill patients.

Seventy-four medical and surgical patients having a minimum of two risk factors for stress-related gastric mucosal bleeding were prospectively selected randomly to receive prophylaxis by antacid titration (to maintain a gastric pH of more than 4) or with sucralfate suspension (1 g/10 ml every four hours). Gastric aspirates were monitored every two hours for pH and overt and occult bleeding. Despite a significantly greater severity of illness in the sucralfate group (p less than 0.01), no significant difference in overt or occult bleeding between the groups could be demonstrated. Low-grade occult blood loss occurred frequently in both groups, but only one of the 74 patients (four risk factors, sucralfate group) had significant stress-related bleeding as defined by preset criteria and documented by endoscopy. The effectiveness of sucralfate appeared unrelated to acid neutralization in keeping with its classification as a cytoprotective agent. There were eight antacid-related side effects (four severe diarrhea, four hypermagnesemia), and none related to sucralfate. Sucralfate suspension was safe and effective and had fewer side effects than antacid titration for the prophylaxis of stress-related bleeding in critically ill patients.

Adult↗
PubMed1984

Antacid versus sucralfate in preventing acute gastrointestinal bleeding. A randomized trial in 100 critically ill patients.

A randomized, controlled trial of sucralfate versus antacid as prophylaxis against upper gastrointestinal bleeding was carried out in 100 critically ill intensive care unit patients. Both groups were comparable with regard to sex, age, duration of prophylaxis, and the number of risk factors per patient. There was no gross bleeding in any of the patients. Three of the 48 sucralfate patients and 2 of the 52 antacid patients showed strongly positive results of Gastroccult tests of three successive hourly samples of gastric aspirate and were considered treatment failures. We conclude that sucralfate therapy is as effective as an antacid regimen in the prevention of gastrointestinal bleeding in critically ill patients. In view of a considerable savings in nursing time, it offers the opportunity for considerable reduction in the cost of intensive care while providing effective protection.

Aluminum↗
PubMed1985

Gender differences in antacid-induced phosphate deprivation in rats.

To determine whether an animal model could be used to study the susceptibility of women to antacid-induced phosphate deficiency, 6-wk-old male and female rats were given basic aluminum carbonate gel (Basaljel) (1 ml/100 g body wt) or distilled water by gastric intubation daily for 3 wk. Rats were fed either ad libitum (group 1) or by pair-feeding (group 2) with pelleted rat food containing 0.74% phosphorus. In group 1, baseline, 1-wk, and 3-wk values for serum phosphorus in Basaljel-treated females were 7.7 +/- 0.2, 6.3 +/- 0.2, and 6.2 +/- 0.2 mg/dl, respectively. Corresponding values for control females were 7.8 +/- 0.3, 7.0 +/- 0.2, and 7.3 +/- 0.2 mg/dl. Values for treated females were significantly lower (p less than 0.02) than values for control females by 1 wk of treatment. Basaljel-treated males did not differ from controls. The pattern for group 2 was similar. Intestinal absorption and intramuscular stores of phosphate were assessed in group 1. After 3 wk of treatment, [32P]phosphate assimilation from the duodenum into the body was lower in Basaljel-treated females than in controls (33.8% +/- 1.9% vs. 49.8% +/- 6.2% of the luminally administered dose, p less than 0.05). This was due to increased retention of [32P]phosphate in the intestine of treated females (19.9% +/- 2.0% vs. 11.9% +/- 2.4% for control females, p less than 0.02). Results in jejunum were similar. Total intramuscular phosphate in females was significantly lower (p less than 0.005) than in males both before and after antacid treatment. Thus hypophosphatemia in the female rat during antacid administration is probably secondary to the additive effects of decreased assimilation and decreased soft tissue stores of phosphate.

Aluminum Hydroxide↗
PubMed1991

Hypophosphatemic rickets with hypocalciuria following long-term treatment with aluminum-containing antacid.

We present what we believe is the first case of rickets following prolonged treatment with aluminum containing antacids that bind phosphate, in an 18-year-old mentally retarded boy with cerebral palsy and spastic quadriplegia. As expected, serum calcitriol was increased and urinary phosphate excretion was very low. However, in contrast to all published cases of antacid induced hypophosphatemic osteomalacia in adults, despite a substantial increase in bone resorption reflected by urinary total hydroxyproline excretion, urinary calcium excretion was low rather than high, and significant hypocalcemia occurred after antacids were ceased and a phosphate salt administered. We suggest that the skeleton was so under-mineralized because of growth during prolonged phosphate deficiency, possibly augmented by anticonvulsant administration and immobilization, that increased bone resorption did not release enough calcium to cause hypercalciuria, or to prevent hypocalcemia during resumption of normal mineralization.

Adolescent↗
PubMed1986

Effect of routine doses of antacid on renal acidification.

Ten healthy volunteers took a magnesium and aluminium hydroxide antacid for 4 days, and their urinary acid excretion was measured. During antacid ingestion, blood bicarbonate levels did not change significantly, but there were highly significant rises in urine pH and bicarbonate excretion and falls in the 24 h excretion of titratable acid, ammonium, and net acid; the average change in net acid excretion was 41 +/- 4 mmol (72 +/- 9%) per 24 h. This large reduction in net acid excretion appears to result from neutralisation of more hydrochloric acid than sodium bicarbonate in the gastrointestinal tract rather than from absorption of exogenous alkali. Although metabolic alkalosis does not occur with their use in normal individuals, these antacids should not be termed "non-systemic". They might cause important changes in renal drug handling, solubility of excreted substances, or acid-base status in patients at risk.

Acid-Base Equilibrium↗
PubMed2001

Effect of pharmacotechnical design on the in vitro interaction of ketoconazole tablets with non-systemic antacids.

In certain polytherapy programs, ketoconazole can be administered with some antacids that could modify its dissolution rate and reduce its absorption leading to therapeutic failures. The aim of this work was to evaluate the influence of some excipients on this interaction in vitro. In this way, six formulations of directly compressible ketoconazole tablets were developed. The results confirmed that the dissolution rate of ketoconazole tablets was significantly reduced in the presence of antacids. Nevertheless this interaction was remarkably avoided in some of the formulations checked and in some conditions. In this way, the inclusion of a disintegrant (sodium starch glycolate) not only increased the dissolution rate of ketoconazole in the tablets, as expected, but it also modified the degree in which the dissolution rate was decreased in the presence of antacids. It was proved that a suitable selection of the excipients and therefore the modification in the rate in which the drug was released, could play an important role to modify a pharmacokinetic interaction based on a reduction of the solubility of the drug as a function of the pH value of the medium.

Antacids↗
PubMed2001

Effect of antacid pretreatment on the pharmacokinetics of AS-924, a novel ester-type cephem antibiotic--comparison with cefteram-pivoxil.

The effect of pretreatment with ranitidine, an antacid, on the absorption of AS-924, a novel prodrug-type cephem antibiotic derived from ceftizoxime (CTIZ), was examined in eight healthy adult male volunteers by the cross-over method, using cefteram-pivoxil (CTER-PI) as the control drug. The C(max) and area under the concentration (AUC) values and cumulative urinary excretion rate (0-24 h) of cefteram (CTER) after administration of CTER-PI decreased by 32, 38 and 37%, respectively, in the ranitidine pretreatment group whereas those of AS-924 were not affected by the antacid. The urinary levels of pivaloyl-carnitine determined to evaluate the solubility of these antibiotics in the gastrointestinal tract suggested that this was not affected by ranitidine. These results indicate that the absorption of CTER-PI was affected by pretreatment with ranitidine largely due to inactivation of this antibiotic in the gastrointestinal tract at high pH rather than to a decrease in solubility. In contrast, isomerization of AS-924 was hardly induced by the elevation of pH, thus demonstrating that AS-924 was less likely to be affected by pretreatment with antacids.

Absorption↗
PubMed1993

Characterization of antacid compounds containing both aluminum and magnesium. II. Codried powders.

The composition and antacid properties of six samples of codried antacids containing both aluminum and magnesium were determined. Aluminum hydroxide-magnesium carbonate codried gel and aluminum hydroxide-magnesium hydroxide codried gel were non-homogeneous, as the samples contained combinations of hydrotalcite, amorphous aluminum hydroxide, magnesium hydroxide, magnesium hydroxycarbonate, and magnesium carbonate. All samples passed the preliminary antacid test and had high acid neutralizing capacities. However, the rate of acid neutralization varied between samples. In some cases the rate of acid neutralization at a dose of 400 mg was too slow to raise the pH to 3.0 as required by the Rossett-Rice test.

Aluminum↗
PubMed1999

Comparison of 200 mg cimetidine with multiple doses of antacid on extent and duration of rise in gastric pH in volunteers.

The effects on gastric pH of a single administration of 200 mg cimetidine (Tagamet HB) were compared to multiple doses of a liquid antacid (Mylanta) using a pH microelectrode. Gastric pH was monitored for 8 hr in 20 normal fasting volunteers in a crossover design to compare Tagamet HB (two 100-mg tablets administered as a single dose) with Mylanta Suspension, an initial 17.5-ml dose of antacid with additional doses given when gastric pH fell below 3.5. Both treatments increased the pH above 3.5 during the first hour following treatment, with Mylanta being more effective than Tagamet HB. Interestingly, to sustain the reduction in acidity during this 1-hr interval, a mean of 2.45 doses of antacid were administered. Although multiple doses of Mylanta kept the pH above 3.5 (for at least 25% of the time) for the first 4 hr, the single administration of 200 mg of Tagamet HB maintained gastric pH above 3.5 (greater than 25% of time) for the full 8 hr of the study. Compared to Mylanta, the percent of time gastric pH was >3.5 was significantly higher with Tagamet HB during the 3rd to 8th hour after dosing. This study demonstrates that 200 mg of cimetidine administered as Tagamet HB is significantly more effective and has a much longer duration of action in raising gastric pH >3.5 than six doses of Mylanta.

Adult↗
PubMed1996

Effects of food and antacid on the pharmacokinetics of single doses of mycophenolate mofetil in rheumatoid arthritis patients.

1. Mycophenolate mofetil (MMF) is a prodrug of mycophenolic acid (MPA) and is being developed for the prevention of rejection following solid organ transplantation. This crossover study investigated the effect of food and antacid (Maalox TC) on the plasma pharmacokinetics of MPA and its inactive glucuronide metabolite MPAG after giving single 2 g MMF doses orally to rheumatoid arthritis patients. 2. With food, the AUC of MPA in plasma was equivalent to that following an overnight fast. MPA tmax was slightly delayed and Cmax was lowered about 25%, consistent with delay in gastric emptying in the fed state. MPAG Cmax and AUC were higher in the fed relative to the fasting state, suggesting more complex processes involving changes in glucuronidation may also be occurring with food. 3. With antacid, AUC of MPA was lowered about 15% compared with fasting and Cmax was decreased 37%. Plasma MPAG parameters were similarly reduced. These parallel changes in MPA and MPAG are consistent with reduced absorption. 4. The changes in MPA with both food and antacid are small in comparison with the interpatient variability and are not likely to have clinically major effects; the changes in MPAG are of mechanistic interest.

Administration, Oral↗
PubMed1976

[Intragastric titration, a method for clinically testing the effect of antacids].

Intragastric titration can be used not only for the quantiative assessment of gastric secretion in healthy subjects and patients with peptic ulcer, but also for differentiating disorders in the regulation of HCI secretion. It is useful foe evaluating the effect of antacids after stimulation of acid secretion with a test meal. The duration of action of an antacid taken about one hour after a meal was much greater than when taken on an empty stomach. Results in 12 healthy subjects indicate that frequent small meals (6 to 8 daily) and antacids between meals greatly reduce gastric acidity. Whether these findings hold true for patients with peptic ulcer remains to be determined.

Adult↗
PubMed1987

[Sodium content of liquid antacid preparations].

The sodium content of 13 liquid antacids was determined using two independent analytical methods (flame photometry). With a neutralisation buffering capacity of 564 mmol/d (pH 3.5) the possible body sodium load was calculated by evaluating the sodium content in the supernatant of the antacid suspensions, ranging from 0.56 to 568 mmol/d (method A) and from 0.42 to 468 mmol/d (method B). Therefore, in patients who are on a sodium restriction of 50 mmol/d this critical intake may be easily exceeded by the intake of certain antacids.

Antacids↗
PubMed1985

[Comparison between cimetidine-pirenzepine and antacids for the prevention of stress hemorrhage in intensive care patients. A controlled clinical study on 125 patients].

In a controlled clinical trial, the efficacy of an intravenous combination of cimetidine and pirenzepine (group A: 62 patients) was compared with that of an intragastric administration of a magnesium-aluminium-hydroxide concentrate (group B: 58 patients) in preventing visible and occult upper gastrointestinal tract bleeding in intensive-care patients. It was found that both forms of therapy had the same favourable effect on the extent and incidence rate of visible and occult gastric bleeding. The antacid was more effective than the cimetidine-pirenzepine combination in raising the pH level to 4 or higher (P less than 0.05). Intensive-care patients should, therefore, be treated with the antacid whenever possible, since it is equally effective as the cimetidine-pirenzepine combination in preventing bleeding from the upper gastrointestinal tract, whereas it is superior in elevating the gastric pH. Besides, the use of the antacid is also less costly.

Adult↗
PubMed1975

Antacids and anticholinergics. Thoughts on how and when to use them.

The antacids and anticholinergics should be considered potent pharmacologic agents with potentially serious side effects. When the conditions constituting major contraindications to these forms of therapy have been considered and their presence has been ruled out, the antacids and anticholinergics are useful in managing the symptoms and course of disease due to the effects of acid and pepsin. Antacid given an hour or so after meals and at bedtime and anticholinergic given at bedtime to selected patients are especially useful in management of peptic ulcer disease. More or less extensive schedules may be indicated, depending on the severity of disease and symptoms.

Alkalosis↗
PubMed1994

Histamine-2-receptor antagonists and antacids in the critically ill population: stress ulceration versus nosocomial pneumonia.

We performed a meta-analysis to evaluate whether stress ulcer prophylaxis with histamine-2-receptor antagonists or antacids reduces mortality in critically ill patients. It appears that sucralfate results in a lower incidence of nosocomial pneumonia than either antacids or histamine-2-receptor antagonists. With respect to mortality, strong trends favored sucralfate over both antacids and histamine-receptor antagonists.

Antacids↗
PubMed1994

Aluminium in antacids and cooking pots and the risk of hip fractures in elderly people.

The relationship between hip fractures and aluminium in antacids and cooking pots was examined in an epidemiological study in Sydney, Australia. A population-based case-control study was conducted and 416 men and women aged 65 years and over were recruited (209 cases and 207 controls). There was a significantly (p < 0.05) increased risk of hip fracture associated with use of aluminium cooking pots at age 20 years: the age- and sex-adjusted odds ratio was 1.9 [95% confidence interval (CI) 1.1-3.2]. No association was detected between risk of hip fracture and current use of aluminium cooking pots or use at age 50. There was some suggestion that long-term use of aluminium-containing antacids might increase the risk of hip fracture: the adjusted odds ratio comparing those who had used aluminium-containing antacids for more than 10 years with those who had never used them was 1.8 (95% CI 0.8-4.1). The findings of this study support the need for further research on the association between oral ingestion of aluminium and risk of hip fracture.

Aged↗
PubMed1976

Treatment of hemorrhagic gastritis by antacid.

A simple and safe method of nonsurgical treatment for the control of massive acute gastric mucosal hemorrhage is described. The procedure was developed from experimental and clinical observations that the presence of gastric hydrocloric acid played an important part in the development and perpetuation of the entity. The treatment consists of complete neutralization of gastric acid with antacid to a pH of 7. The antacid is intermittently added and aspirate at 7. In a retrospective analysis, the hemorrhage was controlled in 44 of 49 patients (89%). Five patients who continued to bleed underwent surgery (10%). Three patients had vagotomy and pyloroplasty and their bleeding ceased without recurrence. Two patients underwent partial gastrectomy, but they developed recurrent bleeding and died. One patient whose bleeding has been controlled by vagotomy and pyloroplasty died without hemorrhage 10 days after operation. Of the 44 patients whose bleeding had been controlled by antacid, 11 patients died without hemorrhage one or more weeks later. These results of 89% control of hemorrhage compare favorably with those in the literature.

Adult↗
PubMed1985

Cimetidine and/or antacid for the control of gastric acidity in pediatric burn patients.

A retrospective study was performed to assess the therapeutic efficacy of cimetidine and antacid, alone and in combination, for the control of gastric acidity and bleeding in pediatric burn patients. The frequency of pH values no greater than 3.5 was significantly greater in the cimetidine group than in the antacid group, and the combined regimen did not enhance the effectiveness of therapy. In all groups, pH values no greater than 3.5 were associated with a significantly higher incidence of positive guaiac tests. In four patients studied prospectively, 63% of the administered dose was detected in the urine 8 h later, compared to the previously reported 24-h delay for normal, healthy adults. Rapid clearance of cimetidine might explain the decreased efficacy of this drug in burn patients. Dosage and schedules for antacid prophylaxis in pediatric burn patients require further study.

Antacids↗