Gastritis, PUD, and GERD: Antacids (Nursing)

00:01 So, after this quick overview of what gastritis, peptic ulcer disease and GERD are, now we're gonna dive into the pharmacology.

00:09 So, let's get started by recalling that what we're trying to accomplish is minimizing the damage from these conditions and we need to protect the stomach lining from the acid.

00:19 So, what are the ways we can do that? How can we protect the stomach lining from the acid? Well, there is more than one way.

00:27 One way is, we can decrease the amount of acid produced, those will be H2 antagonists or PPIs.

00:33 We can neutralize the acid, those would be antacids. We can use a protective coating on the stomach, something like Carafate.

00:40 So let's take a closer look. The first type of drugs we’ll use on patients with gastritis, peptic ulcer disease, and GERD are antacids.

00:50 Now, antacids are like firefighters for your stomach, they neutralize the excess stomach acid. However, when they neutralize excess stomach acid, they also lower the stomach’s ability to break down other medications for absorption.

01:04 So patients need to be taught to take them on their own, meaning they need to wait at least one hour before the next medication or one to two hours after a medication before taking an antacid. Another thing I want you to be very aware of is, I want you to think about kidneys and antacids.

01:28 OK, so we will break this down into a couple points. So, if a client is taking a lot of antacids, especially ones that have aluminum, may take them for a long period of time, this can lead to acute kidney failure.

01:36 If a patient has chronic kidney failure, it can make that worse.

01:39 So you want to use that with caution in anybody with these potential diseases.

01:44 The other thing I want you to remember is that if any patient who’s kind of having trouble with their kidneys, maybe they’re elderly, if they take a lot of antacids they can end up with an excess of the electrolyte that’s in that antacids.

01:59 Examples include magnesium hydroxide, aluminum hydroxide, calcium carbonate, and sodium bicarbonate. These are medications that will end up with excessive magnesium toxicity, or aluminum toxicity, or calcium toxicity, so keep that in mind.

02:14 Now, magnesium hydroxide is a type of antacid that works quickly and has a long-lasting effect. However, it can cause diarrhea as an adverse effect, so it's important not to mix it with other medications.

02:27 Aluminum hydroxide is another type of antacid, but it works more slowly and has a longer-lasting effect.

02:33 However, it can cause constipation as an adverse effect.

02:37 Calcium carbonate is a rapid-acting antacid with a high acid-neutralizing capacity.

02:42 It also has a long-lasting effect.

02:45 However, it can cause constipation, belching, and flatulence as adverse effects.

02:52 Sodium bicarbonate is a type of antacid that works quickly but has a short-lasting effect.

02:57 However, it's not suitable for treating ulcers because it has a high sodium content and can cause alkalosis.

03:03 A good way to remember the antacids is by using the mnemonic CAMS.

03:09 "CAMS" represents the four types of antacids, calcium carbonate, aluminum hydroxide, magnesium hydroxide, and sodium bicarbonate.

03:19 CAMS.