Neutralize Gastric Acid: Antacids and Protect Stomach Lining: Sucralfate and Misoprostol (Nursing)

00:01 So lets talk about those antacids.

00:03 they just neutralize stomach acid in the moment, right? They don't suppress stomach acid, they just neutralize what's there.

00:09 So it coud mean magnesium hydroxide which is milk of magnesia, but that one also has some issues - it can cause diarrhea.

00:17 And so if you pair it with aluminum hydroxide, that can cause constipation but it actually helps us kinda balance things out.

00:25 Now what I want you to watch for is magnesium toxicity in your patients.

00:29 If I have particularly an elderly patient or someone whose kidneys are not functioning well and sometimes it comes in the same patient I have an elderly patient whose kidneys aren't functioning well you want to watch them for signs of magnesium toxicity, what? Okay, if you are taking magnesium hydroxide, that's what you're gonna watch for is, magnesium toxicity.

00:52 Same thing if I'm taking an antacid whose main component is calcium, I'm gonna watch him for signs of calcium toxicity.

01:00 So we'll list those for you in your notes, the signs and symptoms of magnesium toxicity but I want you to be aware when you're on a basic over the counter medication and I have an elderly patient, or someone whose kidneys are not working well, or an old person whose kidneys aren't working well - that's a real danger zone, I'm gonna watch them for toxicity or whatever the component is of that antacid.

01:23 Now sucralfate, that one's a... that's a band-aid for the boo-boo as we say, because it's really sticky, it's this gel that you take orally and it will attach to that ulcer and make up like a liquid bandage in your stomach.

01:38 So it protects that wound against the pepsin and the gastric acid.

01:43 Now it's really almost a risk-free drug, there's a small risk of constipation but it's actually pretty good, there's not really any serious problems with it.

01:54 Misoprostol is the other one that protects the stomach lining.

01:57 It will act as replacement for the endogenous prostaglandins that you have in your body.

02:02 Now endogenous just means that's something that my body normally makes by itself.

02:08 And remember how important prostaglandins are, because they help my body ensure that it has enough mucus and enough bicarbonate in that mucus to neutralize that gastric acid and protect from the pepsin.

02:19 So misoprostol is contraindicated in anyone who is pregnant.

02:24 In fact this is often used as a drug to terminate pregnancies.

02:27 So I would never want to give this medication to someone who is of childbearing years who wanted to have children or we thought might be pregnant.

02:36 This is an absolute not appropriate drug for that.

02:40 Now this one can cause some diarrhea.

02:41 That is kinda cool, no diarrhea is never cool.

02:44 but I'm just telling if you look at these two drugs and we put them together for you to kinda keep in mind, they work differently.

02:51 Sucralfate is gonna coat the sore.

02:53 Misoprostol is gonna kinda replace those prostaglandins.

02:56 Anybody can take sucralfate.

02:59 No one who is pregnant or thinking about being pregnant can take misoprostol.

03:03 Might have constipation with sucralfate but I'm gonna possibly have diarrhea with misoprostol.

03:09 So that's kinda put those together so you can play those off and remember those.

03:13 You might want to draw lines in between or make yourself notes, but that will help it stick in your mind when you're studying