Antacids

• Antacids
  • General:
    • Work for 1-2 hours
  • Magnesium (Increases Motility)
  • Aluminum (Decreases Motility)
  • Calcium Carbonate/Silicate
  • Sodium Bicarbonate
• H2 Receptor Antagonists (H2RAs)
  • MOA: Inhibit binding of histamine, released from enterochromaffin-like cells, at the H2 receptor on parietal cells and thus decreasing the hydrogen ion concentration in the stomach
  • General:
    • Work for 6-10 hours, greater efficacy and can be used for prophylaxis vs antacids
  • Famotidine (Pepcid)
    • Least likely too interfere with P450 enzymes
  • Ranitidine (Zantac)
  • Cimetidine (Tagamet)
    • Inhibits P450 enzymes
• Proton Pump Inhibitors (PPIs)
  • MOA: Decreases hydrogen ion concentration in the stomach by inhibiting the H+/K+ ATPases on parietal cells
    • Only inhibit active proton pumps, leads to weak acid inhibition
    • Need 5-7 days for drug steady state
    • Work faster and are more effective than H2Ras
    • SE: Osteoporosis
      • Nephrotoxic in CKD
  • Esomeprazole (Nexium)
  • Lansoprazole (Prevacid)
  • Omeprazole (Prilosec)
  • Pantoprazole (Protonix)
  • SE: Sporadic fundic gland polyps
• Prostaglandins
  • Misoprostol
  • Enprostil
• Other
  • Bismuth Subcitrate
  • Sucralfate