Antacids

One of the common stomach disorders encountered is gastro esophageal reflux also known as heartburn. The stomach contains hydrochloric acid which helps in digestion of the food and subsequently killing ingested microorganisms. The acidity of the gastric HCl is 2M and any increase in the acidity leads to reflux, in which the gastric HCl travels through the cardiac sphincter muscle to the esophagus causing burning sensation and discomfort. Antacids are common choice of drugs which are administered in these conditions as they reduce the acid reflux and peptic ulcer.

Antacids act locally in the stomach region to neutralize the effect of the gastric HCl in order to prevent the onset of peptic ulcer. Most antacids are not absorbed and they are easily excreted in the stool. The predominant forms of chemicals used in the preparation of antacids include sodium bicarbonate, potassium bicarbonate, aluminum hydroxide, aluminum carbonate, magnesium carbonate, magnesium oxide and calcium carbonate. The natural forms of antacids include ginger, bananas, aloe vera, chamomile (used along with tea), carrots and turmeric. The action of antacids on the stomach is carried out throughout the wall to prevent ulcer formation.

Types of antacids

Antacids are recommended depending upon the intensity of the gastric disorder. In normal or mild conditions of acidity, non systemic antacids are recommended as they do not cause much damage. Prolonged administration of systemic antacids may lead to a condition called alkalosis in which the PH of the blood is raised leading to renal failure. Some of the common types of antacids used in the treatment of reflux and peptic ulcers are:

Sodium bicarbonate: It is recommended by many doctors to treat acid reflux and also reduce the acidity of urine and blood. Antacids which contain sodium bicarbonate also contain baking soda and hence it is not recommended for patients having congestive heart failure, hypertension, kidney disorders and gastrointestinal bleeding. Antacids containing sodium bicarbonate should be taken only after meals on a partially full stomach. The side effects include nausea, flatulence, weakness, increased thirst, black stools and irritability.

Aluminum hydroxide: Aluminum hydroxide is widely used as a non-systemic antacid and in most cases is available without prescription. The side effects of aluminum hydroxide include constipation and abdominal discomfort. In order to avoid constipation and abdominal stress, aluminum hydroxide is given in combination with magnesium hydroxide which has laxative properties along with antacid effects The combination of two such compatible antacids helps in sustained action in relieving peptic ulcers and protecting the wall of the stomach.

Calcium Carbonate: These antacids are mainly used in the treatment of indigestion, flatulence along with acidity and more commonly used as it is less expensive than other types of antacids. They are mostly recommended for children below the age of 12. In patients who have a previous history of osteoporosis or any other type of calcium deficiencies, the intake of calcium carbonate in case of acidity also helps in balancing the calcium requirement. If patients have a history of renal calculi or any other allergic reaction, calcium carbonate antacids should be avoided. The major side effect of this antacid is that it interacts with cardiac drugs. Calcium carbonate based antacids usually disintegrate and dissolute in forty minutes.

Drug side effects

Antacids react with many medications; digoxin, isoniazid, quinidine, pseudoephedrine and tetracycline. The potency and absorption of the drug reduces when the antacids interact with the corresponding drugs.

Aceclofenac

Aceclofenac is a Non Steroidal Anti-Inflammatory Drug (NSAID) that is commonly used for its analgesic (pain-relieving) and anti-inflammatory properties. It is typically prescribed to treat various conditions such as rheumatoid arthritis, osteoarthritis, ankylosing spondylitis and other inflammatory disorders.

Mechanism of Action : Aceclofenac works by inhibiting the production of prostaglandins, which are substances responsible for pain, swelling, and inflammation. It primarily targets the enzyme cyclooxygenase (COX), specifically COX-2, thereby reducing pain and inflammation.

Indications : Aceclofenac is indicated for the relief of pain and inflammation associated with rheumatoid arthritis, osteoarthritis, ankylosing spondylitis, and other musculoskeletal disorders. It can also be used to alleviate postoperative pain, dental pain and gynecological pain.

Dosage and Administration : The dosage of aceclofenac may vary depending on the patient's age, condition, and response. It is typically administered orally as tablets or capsules, with or without food. The recommended initial dose for adults is usually 100 mg twice daily. However, it is essential to follow specific dosing instructions provided by the manufacturer or the prescribing physician.

Contraindications and Precautions : Aceclofenac should be avoided in individuals with a history of hypersensitivity or allergic reactions to NSAIDs, including aspirin. It is also contraindicated in patients with active peptic ulcers, severe heart failure, severe renal impairment and bleeding disorders. Caution should be exercised in patients with a history of gastrointestinal disorders, asthma, hypertension, or compromised renal or hepatic function.

Adverse Effects : Common side effects of aceclofenac include gastrointestinal disturbances such as abdominal pain, dyspepsia, nausea, and diarrhea. Less frequently, it may cause dizziness, headache, skin rash, and elevated liver enzymes. Serious adverse effects like gastrointestinal bleeding, peptic ulcers, renal impairment, and allergic reactions can occur but are relatively rare.
Drug Interactions: Aceclofenac can interact with other medications such as anticoagulants, antiplatelet drugs, selective serotonin reuptake inhibitors (SSRIs), diuretics, and certain antihypertensive agents. It is important to evaluate potential drug interactions and adjust the dosage or consider alternative therapies if needed.
Pregnancy and Lactation : Aceclofenac is contraindicated during the third trimester of pregnancy as it may cause harm to the fetus and complications during delivery. It should also be avoided during breastfeeding as it can be excreted in breast milk.

Aceclofenac belongs to the family of nonsteroidal anti-inflammatory drugs (NSAIDs). Other painkillers in this family include:

• Ibuprofen: Ibuprofen is a commonly used NSAID that provides relief from pain, inflammation, and fever. It is available over-the-counter and in higher doses with a prescription.
  
• Diclofenac: Diclofenac is another NSAID used to reduce pain, inflammation, and swelling. It is available in various formulations such as tablets, capsules, gels, and topical patches.
  
• Naproxen: Naproxen is an NSAID used for the relief of pain, swelling, and stiffness caused by various conditions, including arthritis, tendonitis and menstrual cramps.
  
• Indomethacin: Indomethacin is an NSAID prescribed for the treatment of moderate to severe pain, inflammation, and stiffness associated with conditions like arthritis and gout.
  
• Meloxicam: Meloxicam is an NSAID used for the management of pain and inflammation caused by conditions like rheumatoid arthritis and osteoarthritis.
  
• Ketorolac: Ketorolac is an NSAID available in oral and injectable forms, primarily used for short-term management of moderate to severe pain, such as postoperative pain or pain due to kidney stones.
  

It is important to note that while these medications belong to the same family of NSAIDs, they may have varying potencies, dosing regimens, and potential side effects. The choice of painkiller depends on the individual patient's condition, medical history, and the prescribing physician's judgment. It is advisable to consult with a healthcare professional for proper evaluation and selection of the most suitable painkiller.

Peptic ulcer disease

A person is affected by peptic ulcer disease when there is an open sore in the stomach lining or duodenum. When the ulcer is located in the stomach, it is gastric ulcer while an ulcer found in the duodenum is a duodenal ulcer and an ulcer in the esophagus is an esophageal ulcer. Some of the causes of peptic ulcers are H. pylori bacteria and NSAIDs like aspirin and ibuprofen. Peptic ulcers are not caused by spicy food or alcohol or smoking. But they can worsen existing ulcers. While stress and personality types can worsen a peptic ulcer but it may not be cause for one. Often chronic ulcers are due to gastroesophageal reflux disease.

Persons suffering from peptic ulcer disease feel a dull ache that keeps coming and going. Typically the pain is felt when the stomach is empty. Vomiting and nausea are other symptoms of peptic ulcer disease. In severe cases, the patient suffering from peptic ulcer disease has black, tarry stools and unexplained weight loss. There might be blood in vomit. Upper GI Endoscopy and x-rays of the stomach can help diagnose peptic ulcer disease. Antibiotics are used to destroy bacteria that cause peptic ulcer disease. Antacids help in neutralizing the acid in the stomach. H2 Blockers are medication that control the production of acid thereby allowing the body time to heal.