Review Topic
  • A 50-year-old man presents to his primary care physician for his annual examination. He has a history of hypertension, managed with lifestyle modification but is otherwise healthy and not taking any medication. He reports that his only concern today is that he develops some acid reflux after eating heavy or spicy foods. This occurs especially after he lies down after a big meal. He is instructed to use an over-the-counter antacid, such as calcium carbonate, as needed.
  • Drugs
    • aluminum hydroxide
    • calcium carbonate
    • magnesium hydroxide
  • Mechanism of action
    • neutralizes acid in the stomach
    • delays gastric emptying

Aluminum Hydroxide
Calcium Carbonate
Magnesium Hydroxide
Mechanism of Action
  • Neutralizes acid in the stomach
  • Delays gastric emptying
  • Also acts as a phosphate binder
  • Promotes osmotic retention of fluid and induces diarrhea
Clinical Use of All Antacids
  • Acid reflux
  • Peptic ulcer disease
  • Aluminum hydroxide
Other Clinical Uses
  • Hyperphosphatemia
  • Calcium supplementation
  • Constipation
Adverse effects
  • Constipation
  • Decreased phosphate
    • muscle weakness
    • osteodystrophy
  • Milk-alkali syndrome
    • ↑ calcium
    • in severe cases, can cause metastatic calcification and renal failure
  • Can chelate and decrease the efficacy of some drugs, particularly tetracyclines (doxycycline, tetracycline, and minocycline)
  • Diarrhea
  • Hypotension
  • Cardiac arrest

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