Heartburn is a phenomenon characterized by a burning sensation in the chest. It develops in the event that the stomach is saturated with hydrochloric acid and is thrown into the esophagus. Heartburn can be a symptom of a disease that affects the digestive tract. In order to eliminate it, patients are shown the use of such medicines as antacids. The antacid group includes several dozen varieties of drugs that have some differences from each other. In particular, we are talking about antisecretory drugs.
Pharmacological group of antacids
Antacids are medicines that can neutralize the hydrochloric acid contained in the gastric juice. Thus, the irritating effect of gastric juice on the mucous membranes of the digestive organs is reduced, painful sensations are stopped, and the regeneration of previously damaged areas is accelerated.
It is important to understand that the reason why heartburn occurs, antacids do not eliminate, but only allow to neutralize unpleasant manifestations. This necessitates the appointment of drugs of this group by a specialist, as the arising burning sensation in the chest may indicate the presence of a dangerous pathology, which without timely and adequate therapy can progress and cause a variety of serious complications.
Effects
Against the background of the use of antacid medicines, the following effects develop:
- The mucous membranes lining the digestive tract are enveloped, which helps to protect them from the influence of aggressive factors.
- The excess amount of secreted hydrochloric acid is neutralized.
- Increased pressure in the duodenum, stomach.
- Spastic contractions of the stomach stop.
- It is prevented that the contents of the duodenum are thrown into the stomach.
- The progression of the contents of the stomach is accelerated.
- Bile acids, lysophosphatidylcholine are absorbed.
In what cases are appointed?
The use of antacid medicines is considered appropriate in the following situations:
- With an ulcer and GERD. They are used as an element of complex therapy and can eliminate heartburn and pain.
- In order to eliminate acid-dependent pathological conditions in pregnant women.
- With diseases of the stomach that are provoked by the use of non-steroid medications.
- As a component of complex therapy for inflammation of the gallbladder, pancreas during exacerbation. Antacids are also recommended for cholelithiasis in order to bind excess bile acids in case of indigestion. The classification of antisecretory drugs will be discussed in detail below.
Sometimes antacids are used once by healthy people if heartburn develops against a background of eating disorders.
Classification
It is customary to conditionally classify all antisecretory drugs in pharmacology into two large groups:
- Absorbable.
- Nonabsorbable.
There is also a classification of antisecretory drugs, depending on the main active component in their composition:
- Magnesium-containing antacids. In their composition, the active component may be magnesium carbonate and magnesium hydroxide.
- Containing sodium bicarbonate.
- Containing calcium carbonate.
- Aluminum based antacids. In this case, aluminum phosphate or aluminum hydroxide is used as the active component.
- Combined antacids containing several active ingredients.
Suction preparations
This group of antisecretory drugs includes drugs whose active substances, after interaction with hydrochloric acid, are partially absorbed in the stomach and, thus, penetrate into the systemic circulation.
The main advantage of this group of drugs is their ability to quickly neutralize acidity, thereby relieving heartburn in a short period of time. However, against the background of their use, the development of undesirable effects is noted. In addition, they have a short-term effect. In connection with these shortcomings, absorbed antacid medicines are prescribed to patients much less frequently than non-absorbable ones.
Some of the drugs in this group are capable of releasing carbon dioxide as a result of contact with hydrochloric acid, as a result of which the stomach can stretch, and the secretion of gastric juice resumes.
Characteristic feature
It should be noted that a characteristic feature of absorbed antacids is the occurrence of acid ricochet. It manifests itself immediately after the medication ceases to affect the body. The group of absorbed includes baking soda, which is sodium bicarbonate. As a result of the interaction of the sodium compound with hydrochloric acid, carbon dioxide is released, which provokes the re-secretion of hydrochloric acid in large quantities, which, in turn, provokes the appearance of heartburn. A similar effect makes it recommended not to use baking soda in order to eliminate heartburn. In addition, the sodium present in soda is absorbed in the intestinal tissues, causing the development of swelling, and this is an undesirable phenomenon for patients suffering from pathologies of the kidneys and heart, pregnant women.
The group of absorbable antisecretory drugs include such medicines as Vicalin, Vicair, and Rennie. The main active substances in their composition are: calcium or magnesium carbonate, magnesium oxide, sodium bicarbonate.
Their mechanism of action for heartburn is similar to that of baking soda. However, in the process of neutralizing hydrochloric acid, carbon dioxide is not released, which is undoubtedly a plus, since there is no negative effect on the patient's well-being. It is important to consider that the therapeutic effect of such medications persists for a short period.
Only a single dose of antisecretory drugs of this group is allowed, if there is an urgent need. It should be borne in mind that their use over a long period of time can cause exacerbations. The progression of such pathologies of the digestive tract as a gastric ulcer is not ruled out.
Non-absorbable antacids
The list of antisecretory drugs is quite extensive. Compared to the group of absorbable drugs, nonabsorbable ones are more effective, and the spectrum of undesirable effects arising from them is much narrower.
Preparations related to nonabsorbable antacids can be conditionally classified into three subgroups:
- Having as its active component aluminum phosphate. Phosphalugel in gel form belongs to this category of medicines.
- Magnesium-aluminum antacids, which include the following drugs: "Almagel", "Maalox", "Gastratsid".
- Combined antacids, in which, in addition to magnesium and aluminum salts, there are other substances. This group includes gel antacids containing simethicone or anesthetics, for example, Almagel Neo, Reltser.
The main substances of these medicines of the gastric mucosa are absorbed only in small quantities, then they are evacuated with urine. In the event that the patient suffers from a severe form of renal failure, it may be difficult to evacuate aluminum. In this regard, caution must be exercised when prescribing these medicines for this category of patients.
Preparations of the group of non-absorbable antacids are able to neutralize, in addition to hydrochloric acid, also bile and pepsin. After entering the body, they envelop the mucous layers of the stomach, thereby protecting its walls from aggressive substances. In addition, they are able to activate the regeneration of damaged tissues.
Their therapeutic effect develops within 15 minutes, can persist up to 4 hours.
Negative reactions
When using medicines of the group of nonabsorbable antacids, the following negative reactions may develop:
- When using excessive dosages, there is a possibility of mild drowsiness. This risk increases if the patient has pathological abnormalities in the activity of the kidneys.
- Antisecretory agents, which contain calcium or aluminum salts, can provoke difficulties associated with bowel movements.
- Magnesium-based antacids have the ability to have a laxative effect, quite often provoke various digestive disorders.
- If the patient has individual hypersensitivity, then negative effects such as vomiting and nausea may be noted. The appearance of such signs indicates the need to replace the drug used with its analogue.
- It is not excluded the development of allergic manifestations, expressed in rashes on the skin. In such cases, the patient is advised to stop using antacid and consult a doctor.
Basic Terms of Use
Antacid medicines are produced by manufacturers in various pharmacological forms. This can be a gel, chewable tablets, suspensions, tablets intended for resorption. The effectiveness of various pharmacological forms of the same medication is the same.
Multiplicity of receptions
The multiplicity of receptions and the necessary dosage should be selected individually. As a rule, the patient is recommended to take antacids after eating, having sustained a two-hour break, as well as before bedtime.
It must be remembered that the use of antacids in parallel with other drugs is unacceptable. This is due to the fact that any drugs in the presence of antacids will not be absorbed. Between receptions of antacid and antisecretory drugs should take a break of 2 hours.