Question

J.H., a 48-year-old man, complains of a gnawing, aching pain in the abdominal area that usually occurs several hours after eating which has been going on for about six months. He often times feel very nauseated on and off throughout the day as well. He says that sometimes he takes triple the dosage of over the-counter antacids which help some, but that the pain has recently intensified. 1. Explain how antacids work. What concerns with the amount of antacids J.H is taking? 2. Explain the patient teaching for magnesium containing antacids versus aluminum containing antacids, including rationale.

Answer 1

1, Antacid reduces the acidity in the stomach by reducing the amount of acid refluxed in the esophagus. It inhibits the pepsin activity in the stomach when we take antacid after the meal about after 1 hour, it reduces acid for 3 hours due to food, it slows the emptying of the antacid for the stomach.
When we take a high dose of antacid for a long period it causes acid rebound. It defined as it which the stomach produces more acid after the consumption of foods. it causes rebound hyperacidity and milk-alkali syndrome.
2, Magnesium containing antacid have the laxative effect it causes diarrhea.
- Advice the patient in case of any renal disease patient should be considered taking an antacid because it increases the magnesium level in the blood, it slows down the kidney ability to remove magnesium from the body in the urine.
Albumin hydroxide containing antacid cause hypophosphatemia which leads to muscle weakness, osteomalacia, and anorexia.
Advice the patient to avoid this type of antacid if the patient suffered from a gastrointestinal disorder or bleeding. it causes constipation, albumin -intoxication.
3, Standard Triple therapy(amoxicillin, tetracycline, and esomeprazole) consists of one proton-pump inhibitor (PPI). H.pylori is a common bacterial infection in peptic ulcer disease it develops resistance to antibacterial standard first-line therapy, also acquisition acquires from other bacteria. the low dose of amoxicillin and tetracycline with high-dose metronidazole can overcome antibiotic resistance. it can eradicate the H.pylori.
4, Esomeprazole drug class called proton pump inhibitors(PPI) that block the production of acid by the stomach.
5, -Advice the patient not to use this drug for a long period which causes low magnesium level and risk for heart attack and poor absorption of vitamin B12.
-Advice the patient to take the medicine one hour before the meal
-Explain the patient about side effects and contact the physician in case of an emergency.