Antacid Nursing Pharmacology Study Guide

Learn about the different antacids in this nursing pharmacology study guide.

Antacids are used to chemically react with and neutralize the acid in the stomach. They can provide rapid relief from increased acid levels. They are known to cause GI alterations such as diarrhea or constipation and can alter the absorption of many drugs.

Antacids: Generic and Brand Names

Here is a list of the most commonly encountered antacids and their brand names.

ClassificationGeneric nameBrand name
Antacidsaluminum saltsAlternaGEL
calcium saltsOystercal, Tums
magaldrateLosopan, Riopan
magnesium saltsMilk of Magnesia, others
sodium bicarbonateBell-ans

Disease Spotlight: Ulcer Disease

Erosions in the lining of the stomach and adjacent areas of the GI tract are called peptic ulcer.

  • Ulcer patients present with a predictable description of gnawing, burning pain often occurring a few hours after meals.
  • Many of the drugs that are used to affect GI secretions are designed to prevent, treat, or aid in the healing of these ulcers.
  • Further research led many to believe that, because acid production was often normal in ulcer patients, ulcers were caused by a defect in the mucous lining that coats the inner lumen of the stomach to protect it from acid and digestive enzymes.
  • Treatment was aimed at improving the balance between the acid produced and the mucous layer that protects the stomach lining.

What are antacids?

Antacids are a group of inorganic chemicals that neutralize stomach acid.

  • Antacids are available OTC, and many patients use them to self-treat a variety of GI symptoms.
  • The choice of an antacid depends on adverse effects and absorption factors.

Therapeutic actions

The desired actions of antacids include the following:

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  • Neutralize stomach acid by direct chemical reaction.
  • Symptomatic relief of an upset stomach associated with hyperacidity, as well as the hyperacidity associated with peptic ulcer, gastritis, peptic esophagitis, gastric hyperacidity, and hiatal hernia.

Indication

Antacids are indicated for the following:

  • Symptomatic relief of GI hyperacidity, treatment of hyperphosphatemia, prevention of formation of phosphate urinary stones.
  • Treatment of calcium deficiency, prevention of hypocalcemia.
  • Prophylaxis of stress ulcers, relief of constipation.

Pharmacokinetics

Many of these antacids are available in combination forms to take advantage of the acid-neutralizing effect and block adverse effects.

RouteOnsetPeakDuration
OralRapid30 min1-3h
IVImmediateRapidUnknown
T 1/2: Unknown
Excretion: Unchanged in urine

Contraindications and Cautions

The following are contraindications and cautions when using antacids:

  • Allergy. The antacids are contraindicated in the presence of any known allergy to antacid products or any component of the drug to prevent hypersensitivity reactions.
  • Co-morbidities. Caution should be used in the following instances: any condition that can be exacerbated by electrolyte or acid-based imbalance to prevent exacerbations and serious adverse effects; any electrolyte imbalance , which could be exacerbated by the electrolyte-changing effects of these drugs; GI obstruction which could cause systemic absorption of the drugs and increase adverse effects; renal dysfunction, which could lead to electrolyte disturbance if any absorbed antacid is neutralized properly.
  • Pregnancy and lactation. Antacids are contraindicated for pregnant and lactating women because of the potential for adverse effects on the fetus or neonate.

Adverse effects

Adverse effects when using antacids include:

Interactions

Antacids can greatly affect the absorption of drugs from the GI tract.

  • Alkalinity. Most drugs are prepared for an acidic environment, and an alkaline environment can prevent them from being broken down for absorption or can actually neutralize them so that they cannot be absorbed.

Nursing considerations

Nursing considerations for a patient using antacids include the following:

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Nursing Assessment

History taking and physical exam in a patient using antacids include:

  • Assess for possible contraindications and cautions: any history of allergy to antacids to prevent hypersensitivity reactions; renal dysfunction, which might interfere with the drug’s excretion; electrolyte disturbances, which could be exacerbated by effects of the drug; and current status of pregnancy or lactation due to possible effects on the fetus or newborn.
  • Perform a physical examination to establish baseline data before beginning therapy, determine the effectiveness of the therapy, and evaluate for any potential adverse effects associated with the drug.
  • Inspect the abdomen; auscultate bowel sounds to ensure GI motility.
  • Assess mucous membrane status to evaluate potential problems with absorption and hydration.
  • Monitor laboratory test results, including serum electrolyte levels and renal function tests, to monitor for adverse effects of the drug and potential alterations in excretion that may necessitate dose adjustment.

Nursing Diagnosis and Care Planning

Nursing diagnoses related to drug therapy might include the following:

  • Diarrhea related to GI effects.
  • Risk for constipation related to GI effects.
  • Imbalanced nutrition: less than body requirements related to GI effects.
  • Risk for imbalanced fluid volume related to systemic effects.
  • Deficient knowledge regarding drug therapy.

Nursing Implementation with Rationale

The nursing interventions for patients using antacids are:

  • Adequate drug absorption. Administer the drug apart from any other oral medications approximately 1 hour before or 2 hours after to ensure adequate absorption of the other medications.
  • Ensure therapeutic levels. Have the patient chew tablets thoroughly and follow with water to ensure that therapeutic levels reach the stomach to decrease acidity.
  • Perform diagnostic testing. Obtain specimens for periodic monitoring of serum electrolytes to evaluate drug effects.
  • Prevent imbalances. Assess the patient for any signs of acid-base or electrolyte imbalance to ensure early detection and prompt interventions.
  • Institute a bowel program. Monitor the patient for diarrhea or constipation to institute a bowel program before severe effects occur.
  • Ensure adequate nutritional status. Monitor the patient’s nutritional status if diarrhea is severe or constipation leads to decreased food intake to ensure adequate fluid and nutritional intake to promote healing and GI stability.
  • Provide patient support. Offer support and encouragement to help the patient cope with the disease and the drug regimen.
  • Educate the patient. Provide thorough patient teaching, including the drug name and prescribed dose, schedule for administration, signs and symptoms of adverse effects and measures to prevent or minimize them, warning signs that may indicate possible problems and the need to notify the health care provider immediately.

Evaluation

Evaluation of a patient using antacids include:

  • Monitor patient response to the drug (relief of GI symptoms caused by hyperacidity).
  • Monitor for adverse effects (GI effects, imbalances in serum electrolytes, and acid-base status).
  • Evaluate the effectiveness of the teaching plan (patient can name the drug and dosage, as well as describe the adverse effects to watch for, specific measures to avoid them, and measures to take to increase the effectiveness of the drug).
  • Monitor the effectiveness of comfort measures and compliance with the regimen.

Practice Quiz: Antacids

Here’s a 5-item quiz for this antacid study guide:

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Practice Quiz: Antacids

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Practice Quiz: Antacids

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1. Which of the following statements describes the action of antacids?

A. Antacids block the production of gastric acid
B. Antacids enhance the action of acetylcholine
C. Antacids block dopamine
D. Antacids neutralize gastric acid

1. Answer: D. Antacids neutralize gastric acid

  • Option D: Antacids act to bring the pH above 3.
  • Options A, B, and C: Other choices are incorrect because they describe actions of antiacid drugs.

2. Patient Gavin is taking antacids, which instruction would be included in the teaching plan?

A. “Avoid taking other medications within 2 hours of this one.”
B. “Continue taking antacids even when pain subsides.”
C. “Weigh yourself daily when taking this medication.”
D. “Take the antacids with 8 oz of water.”

2. Answer: A. “Avoid taking other medications within 2 hours of this one.”

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  • Option A: The client should be instructed to avoid taking other medications within 2 hours of the antacid.
  • Option B: A histamine receptor antagonist should be taken even when the pain subsides.
  • Option C: Daily weights are indicated if the client is taking a diuretic, not an antacid.
  • Option D: Water, which dilutes the antacid, should not be taken with an antacid.

3. Nurse Victoria is teaching a group of middle-aged men about peptic ulcers. When discussing risk factors for peptic ulcers, the nurse should mention:

A. A history of hemorrhoids and smoking
B. A sedentary lifestyle and smoking
C. Alcohol abuse and smoking
D. Alcohol abuse and a history of acute renal failure

3. Answer: C. Alcohol abuse and smoking

  • Option C: Risk factors for peptic (gastric and duodenal) ulcers include alcohol abuse, smoking, and stress.
  • Options A & B: A sedentary lifestyle and a history of hemorrhoids aren’t risk factors for peptic ulcers.
  • Option D: Chronic renal failure, not acute renal failure, is associated with duodenal ulcers. 

4. Which of the following tests can be used to diagnose ulcers?

A. Barium swallow
B. Abdominal x-ray
C. Esophagogastroduodenoscopy (EGD)
D. Computed tomography (CT) scan

4. Answer: C. Esophagogastroduodenoscopy (EGD)

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  • Option C: The EGD can visualize the entire upper GI tract as well as allow for tissue specimens and electrocautery if needed.
  • Option A: The barium swallow could locate a gastric ulcer.
  • Options B and D: A CT scan and an abdominal x-ray aren’t useful in the diagnosis of an ulcer.

5. The hospitalized client with GERD is complaining of chest discomfort that feels like heartburn following a meal. After administering an ordered antacid, the nurse encourages the client to lie in which of the following positions?

A. On the stomach with the head flat
B. Supine with the head of the bed flat
C. On the right side with the head of the bed elevated 30 degrees
D. On the left side with the head of the bed elevated 30 degrees

5. Answer: D. On the left side with the head of the bed elevated 30 degrees.

  • Option D: The left side-lying position with the head of the bed elevated is most likely to give relief to the client.
  • Options A, B, C: These include lying flat on the back or on the stomach after a meal or lying on the right side.

Sources and References

The following are the recommended supplemental reading for this antacid nursing pharmacology study guide:

Antacid Nursing Pharmacology Study Guide

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