Antacid

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An antacid (plural: antacid ) is a medicine used to neutralize stomach acid . It is a weak base or the salt of a weak acid , so its mechanism of action can be explained, among other things, by the buffering of gastric acid.

The area of ​​application for antacids is the symptomatic treatment of diseases in which gastric acid is to be bound. These include heartburn , acid regurgitation, and acid-induced stomach pain. Most of the time, however, antacids are used as over -the- counter self-medication for reflux esophagitis (inflammation of the esophagus).

The previously often used sodium - (short soda , outdated trivial names bicarbonate of soda or sodium bicarbonate , as colloquially baking soda or baking soda ) - is obsolete as an antacid. It quickly leads to an increase in the intragastric pH value (above 7), as a result of which more gastrin is released, which in turn leads to a reactively increased secretion of gastric acid. The rapid development of CO 2 in the stomach is subjectively unpleasant . In addition, the sodium ions are completely absorbed, so that systemic undesirable effects such as hypernatremia , risk of metabolic alkalosis , edema formation , and hypertension can occur when large doses are taken or over a long period of time .

This is why aluminum and magnesium hydroxide gels as well as mixtures of calcium and magnesium carbonate or aluminum-magnesium silicate hydrate, which is contained in the active ingredient almasilate , became popular in the 1970s . Not only are they less absorbed and therefore only work in the stomach, they are also characterized by better tolerance. In addition, aluminum-containing antacids such as sucralfate stimulate gastric mucus production as they increase prostaglandin synthesis .

Patients with renal insufficiency should be careful because chronic use of antacids can lead to an accumulation of aluminum and magnesium hydroxide in the body. Antacids also impair iron absorption by increasing the pH of the gastric juice. For some time now, aluminum has also been suspected of being responsible for damage to the nervous system and as a cause of Alzheimer's disease . (See aluminum toxicity )

In recent years, antacids have become less important in the treatment of gastric ulcers. This is due to the breakthrough of so-called H 2 antagonists and proton pump inhibitors , which directly inhibit gastric acid production and therefore work longer and more effectively.

Layered grid antacids

Layered grid antacids are 2nd generation active ingredients and differ significantly from conventional antacids. There are currently two active substances on the market, magaldrate (e.g. Riopan ) and hydrotalcite (e.g. Talcid ).

Aluminum hydroxide can cause constipation , whereas magnesium hydroxide stimulates bowel movements and has a laxative effect. That is why most of the ready-to-use products offered today are mixtures of both active ingredients. The combination of calcium and magnesium carbonate is also frequently used.

More recent findings since 2010

Scientific findings on the uptake of aluminum salts in the human organism were re-evaluated and led various national health authorities to limit the daily intake. Entry routes are possible via food, medical products and consumer goods.

Individual evidence

  1. a b W. Forth, D. Henschler, W. Rummel: General and special pharmacology and toxicology . 9th edition. URBAN & FISCHER, Munich 2005, ISBN 3-437-42521-8 .
  2. Ernst Mutschler et al .: Mutschler - drug effects textbook of pharmacology and toxicology . 9th edition. Scientific Verlagsgesellschaft, Stuttgart 2008, ISBN 978-3-8047-1952-1 .
  3. The dubious all-rounder, SRF documentation 2012 , similar documentation in ARTE, YouTube and VEOH have since been deleted. See also wiki discussions .