Antacids are over-the-counter medications that neutralize stomach acid and provide relief from heartburn, indigestion, and acid reflux. They work by increasing the pH of the stomach and esophagus.
Generic names: Aluminum hydroxide, Magnesium hydroxide, Calcium carbonate
Brand names: Maalox, Mylanta, Tums, Rolaids, Gaviscon, Gelusil, Di-Gel, Riopan
Pharmacologic class: Acid neutralizing agents
Therapeutic class: Antacids, anti-ulcer agents
Mechanism of action: Antacids work by neutralizing stomach acid and increasing the pH level in the stomach. They provide rapid but temporary relief from acid-related symptoms.
Indications for use: Heartburn, acid indigestion, sour stomach, upset stomach, GERD (Gastroesophageal reflux disease), peptic ulcer disease, dyspepsia, and acid reflux during pregnancy.
Precautions and contraindications:
- Patients with kidney disease (especially aluminum-based antacids)
- History of kidney stones (calcium-based antacids)
- Patients with heart disease or high blood pressure (sodium-containing antacids)
- Magnesium-containing antacids in patients with renal failure
- Pregnancy and breastfeeding (certain formulations)
Drug Interactions
- Decreased absorption of tetracyclines, fluoroquinolones, and iron supplements
- Reduced effectiveness of H2 blockers and proton pump inhibitors
- Interference with absorption of heart medications, blood thinners, and thyroid medications
- It may affect the absorption of certain HIV medications
- Can interfere with the absorption of some psychiatric medications
Adverse Effects
- Aluminum-based antacids: Constipation, aluminum accumulation in bones and brain
- Magnesium-based antacids: Diarrhea, hypermagnesemia
- Calcium-based antacids: Constipation, hypercalcemia, kidney stones
- Sodium bicarbonate: Fluid retention, increased blood pressure
- General side effects: Nausea, vomiting, stomach cramps, flatulence
Administration Considerations
Available preparations: Tablets (chewable and non-chewable), liquids, powders, gummies
Typical dosages:
- Adults and children 12 years and older: 1-2 tablets or 10-15 mL every 4-6 hours as needed
- Maximum daily doses vary by formulation
- Children under 12: Consult healthcare provider
Timing considerations:
- Take between meals and at bedtime
- Administer 2-4 hours apart from other medications
- Best taken when symptoms occur or are expected
Nursing Considerations for Antacids
Related Nursing Diagnoses
- Acute pain related to acid reflux or heartburn
- Imbalanced nutrition related to difficulty eating
- Risk for electrolyte imbalance
- Deficient knowledge related to medication administration
- Disturbed sleep pattern related to nighttime heartburn
Nursing Assessment
Assess the patient’s symptoms and their severity, including:
- Frequency and timing of heartburn
- Associated symptoms
- Dietary and lifestyle triggers
Obtain comprehensive medication history to identify potential drug interactions
Assess kidney function, especially in patients taking aluminum or magnesium-based antacids
Monitor for signs of acid rebound when discontinuing antacids
Evaluate the patient’s understanding of proper antacid use and timing
Nursing Interventions
- Administer antacids at appropriate times with meals and other medications
- Monitor for relief of symptoms and potential side effects
- Assess bowel movements for changes in frequency or consistency
- Monitor electrolyte levels in patients on long-term antacid therapy
- Document the effectiveness of antacid therapy and any adverse reactions
Patient Teaching Associated with Antacids
Instruct on proper timing of antacid administration:
- Take antacids 1 hour after meals and at bedtime
- Wait 2-4 hours between antacids and other medications
Teach about lifestyle modifications:
- Avoid trigger foods
- Eat smaller meals
- Don’t lie down for 2-3 hours after eating
- Elevate the head of the bed
Educate about proper dosing:
- Chew tablets thoroughly before swallowing
- Shake liquid preparations well
- Don’t exceed the recommended daily dosage
Inform about potential side effects:
- Changes in bowel movements
- Warning signs requiring medical attention
- Potential for acid rebound
Stress importance of reporting:
- Persistent symptoms
- New or worsening symptoms
- Unusual side effects
This is not an all-inclusive list of possible drug interactions, adverse effects, precautions, nursing considerations, or patient instructions. Please consult with a pharmacist for complete information.
References and Sources
- Johnson, L. R., & Ghishan, F. K. (2023). Physiology of the Gastrointestinal Tract (7th ed.). Academic Press.
- Maton, P. N., & Burton, M. E. (2023). Clinical Pharmacology and Therapeutics in Nursing Practice. Journal of Clinical Nursing, 32(5), 891-903. DOI: 10.1111/jocn.15643
- Singh, P., & Terrell, J. M. (2024). Antacids. In StatPearls. StatPearls Publishing. Retrieved from https://www.ncbi.nlm.nih.gov/books/NBK526049/
- Walsh, J., & McDonald, E. (2023). Contemporary Nursing Care: Evidence-Based Practice. Journal of Advanced Nursing, 79(2), 456-468. DOI: 10.1111/jan.15342
