Antacids
Kelas obat: Agen Antineoplastik
Panganggone Antacids
Ulser Peptik
Tambahan kanggo obat liya (contone, anti-infèksi, antagonis reseptor histamin H2, inhibitor pompa proton) kanggo ngilangake nyeri ulkus peptik lan ningkatake penyembuhan ulkus peptik.
Amarga regimen sing ora trep sing dibutuhake kanggo ningkatake penyembuhan ulkus, tingkat kambuh sing dhuwur, ora efektif kanggo ngilangi Helicobacter pylori, masalah palatability, lan efek samping, antacid arang digunakake maneh kanggo perawatan ulkus peptik. penyakit. Nanging, antacid saiki digunakake utamane minangka tambahan kanggo rejimen antiulser liyane kanggo nyuda nyeri ulkus peptik sing dibutuhake (prn).
Asam Asam
Obat mandhiri kanggo ngilangi asam lara (dyspepsia), mulas, lan weteng kecut lan/utawa kembung (biasane diarani gas).
Gastroesophageal Reflux Disease (GERD)
Obat-obat mandiri kanggo ngobati GERD sing entheng (contone, gejala sing disebabake dening panganan sing nyebabake heartburn).
Antacid umume nyedhiyakake gejala GERD sing luwih cepet nanging luwih suwe tinimbang karo antagonis reseptor histamin H2, lan terapi gabungan umume luwih efektif tinimbang salah siji kelas obat kasebut.
Konsultasi karo dhokter. dokter yen gejala tetep utawa tandha-tandha peringatan GERD sing luwih abot (contone, dysphagia, getihen, mundhut bobot, keselak [batuk sing disebabake asam, sesak ambegan, lan / utawa serak], nyeri dada).
Agen liyane (contone, antagonis reseptor histamin H2, inhibitor pompa proton) sing disenengi dening American College of Gastroenterology (ACG) lan American Gastroenterological Association (AGA) kanggo ngatur GERD sing luwih abot.
Wis digunakake kanggo obat mandiri kanggo ngilangi gejala terobosan ing pasien sing nampa inhibitor pompa proton.
Hiperfosfatemia
Antacid sing ngandhut aluminium (kajaba aluminium fosfat): Manajemen hiperfosfatemia utawa nyegah kalkulus ginjal fosfat sing berulang (sandhingan karo diet fosfat rendah).
Aluminium karbonat umume luwih disenengi tinimbang aluminium hidroksida kanggo panggunaan iki.
Pengganti Kalsium
Kalsium karbonat digunakake kanggo suplemen kalsium.
Ulserasi Stress lan Perdarahan GI
Wis digunakake kanggo nyegah ulcerasi stres† [off-label] lan getihen GI† [off-label].
Aspirasi Asam lambung
Wis digunakake kanggo nyegah aspirasi asam lambung† [off-label] ing pasien sing ngalami operasi caesar utawa operasi darurat; umume wis diganti karo antagonis reseptor H2 histamin utawa larutan sitrat.
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- Unisom
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- Valoctocogene Roxaparvovec
- Valproate/Divalproex
- Valproate/Divalproex
- Vanspar
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- Varenicline (Systemic)
- Varenicline Tartrate (EENT)
- Vecamyl
- Vitamin B12
- Vonoprazan, Clarithromycin, and Amoxicillin
- Wytensin
- Xyrem
- Xywav
- Zaleplon
- Zirconium Cyclosilicate
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Carane nggunakake Antacids
Administrasi
Administrasi Lisan
Administrasi kanthi lisan.
Suspensi oral luwih cepet lan larut kanthi efektif tinimbang bubuk utawa tablet; cadangan tablet lisan kanggo panggunaan kronis ing pasien sing nolak suspensi oral amarga rasa ora nyaman utawa rasa ora enak. Tablet sing disintegrasi kanthi cepet bisa dadi alternatif sing cocok kanggo sawetara pasien.
Mamah tablet, kalebu tablet sing larut kanthi cepet, sak tenane sadurunge ditelan.
Dosis
Kasedhiya ing macem-macem anorganik. uyah (umpamane, aluminium karbonat, aluminium hidroksida, kalsium karbonat, magnesium hidroksida, magnesium oksida, natrium bikarbonat); dosis dituduhake ing mEq kapasitas netralisasi asam.
Dosis lan frekuensi administrasi gumantung saka tingkat sekresi asam lambung, wektu ngosongake lambung, lan kelainan sing diobati.
Dewasa
Ulkus PeptikKanggo penyakit ulcer peptik, dosis antasida empiris lan macem-macem dosis antasida wis digunakake.
Terapi Adjunctive OralKanggo nyuda nyeri ulkus tambahan, asam 40–80 mEq kapasitas netralisasi kanthi basis (prn) sing dibutuhake.
Perawatan LisanTerapi liyane saiki luwih disenengi kanggo perawatan ulkus peptik aktif. (Deleng Ulkus Peptik ing Panggunaan.)
Yen antasida digunakake kanggo ngobati ulkus peptik, regimen dosis dhuwur sing biasa kanggo penyembuhan ulcer nggunakake kapasitas netralisasi asam 80-160 mEq, diwenehi 1 lan 3 jam sawise mangan. lan nalika turu.
Dosis tambahan saka antacid bisa diwènèhaké kanggo nyuda nyeri ulcer sing dumadi ing antarane dosis sing dijadwalake kanthi rutin.
Ing pasien ulkus duodenum, antacid biasane diwenehake sajrone 4-6 minggu. Yen gejala ulkus duodenum kambuh, antacid bisa diwènèhaké 1 lan 3 jam sawise mangan lan sadurunge turu kanggo 1 minggu lan, yen pain wis ilang, kurang asring kanggo tambahan 1-2 minggu.
Ing pasien karo ulkus lambung, antacid diwènèhaké nganti penyembuhan rampung.
Gastroesophageal Reflux Disease (GERD)Kanggo GERD, dosis antasida empiris lan manéka dosis antasida wis digunakake.
OralKanggo nyuda heartburn, siji regimen sing disaranake nggunakake kapasitas netralisasi asam 40-80 mEq kanthi basis (prn) sing dibutuhake. Yen perlu, dosis bisa dititrasi kanthi jadwal rutin kayata kapasitas netralisasi asam 40-80 mEq sing diwenehake sawise mangan lan sadurunge turu.
Hiperfosfatemia OralMagepokan karo pembatasan diet fosfat ing manajemen hiperfosfatemia, 30-40 mL aluminium hidroksida utawa suspensi aluminium karbonat diwenehake 3 utawa 4 kaping saben dina.
Stress Ulceration lan GI Bleeding OralIng manajemen stress ulceration† [off-label] lan GI bleeding† [off-label], antasida biasane diwenehake saben jam, lan dosis antacid kudu dititrasi kanggo njaga aspirasi nasogastrik ing ndhuwur pH 3,5.
p>Kanggo gejala sing abot, suspensi antasida bisa diencerake nganggo banyu utawa susu lan diwenehake kanthi infus intragastrik sing terus-terusan.
Aspirasi Asam Lambung OralKanggo nyuda resiko aspirasi asam lambung sing disebabake dening anestesi, antacid suspensi wis diwenehi 30 menit sadurunge anestesi.
Watesan Resep
Dewasa
GERD OralAja ngluwihi kapasitas netralisasi asam 500-600 mEq saben dina utawa dijadwal kanthi rutin ( versus sing dibutuhake; prn) terapi luwih saka 2 minggu terus-terusan.
Natrium BikarbonatDosis natrium utawa bikarbonat saben dina maksimal yaiku 200 mEq ing pasien <60 taun lan 100 mEq ing pasien sing umure >60 taun. Kontraindikasi kanggo terapi sing dawa amarga bisa nyebabake alkalosis metabolik utawa kakehan sodium.
Pènget
Kontraindikasi
Pènget/PanandhapPènget
Phenylketonuria
Sawetara antacid bisa ngemot aspartam (contone, NutraSweet), sing dimetabolisme ing saluran GI dadi fenilalanin sawise administrasi oral.
Reaksi Sensitivitas
Sensitivitas TartrazineSawetara formulasi antasida ngemot pewarna tartrazine (FD&C kuning No. 5), sing bisa nyebabake reaksi alergi (asma bronkial ing individu sing rentan) ing individu sing rentan tartamtu (contone, pasien sing sensitif marang aspirin).
Pancegahan Umum
Antacid AluminiumRisiko hipofosfatemia kanthi administrasi sing dawa utawa dosis gedhe, utamane ing pasien kanthi asupan fosfor sing ora nyukupi.
Ngawasi konsentrasi fosfat serum ing interval saben wulan utawa rong wulan. ing pasien hemodialisis pangopènan sing nampa terapi antasida aluminium kronis.
Kalsium KarbonatBisa nyebabake hipersekresi lambung lan rebound asam.
Bisa nyebabake sindrom susu-alkali (ditandai kanthi hiperkalsemia, metabolisme alkalosis lan, arang, insufficiency ngenani babagan ginjel).
Monitor konsentrasi kalsium serum saben minggu lan kapan ana manifestasi hiperkalsemia ing pasien sing nampa kalsium karbonat dosis gedhe.
Antacid MagnesiumBiasa nyebabake efek laxative. , lan asring administrasi antacids iki piyambak asring ora bisa ditrima; dosis bola-bali nyebabake diare sing bisa nyebabake ketidakseimbangan cairan lan elektrolit.
Natrium BikarbonatBisa nyebabake alkalosis metabolik nalika diwenehi dosis gedhe.
Kesalahan PengobatanKasalahan obat sing serius wis dilaporake menyang FDA sing Konsumen nggunakake Maalox Total Relief (bismuth subsalicylate) nalika arep nggunakake produk antacid cair Maalox tradisional sing ngemot aluminium hidroksida, magnesium hidroksida, lan simethicone (contone, Maalox Advanced Regular Strength, Maalox Advanced Maximum Strength). Amarga saka potensial kanggo efek salabetipun serius gadhah ora sengaja nggunakake bismuth subsalicylate (kang kimia related kanggo aspirin), Produsèn saka Maalox Total Relief pisanan sarujuk kanggo ngganti jeneng dagang produk kanggo siji sing ora kalebu "Maalox"; Nanging, pabrikan malah mandhegake persiapan bismuth subsalicylate ing musim panas 2010.
Populasi Spesifik
Gagal GinjalAntacid Aluminium: Administrasi jangka panjang ing pasien gagal ginjal utawa gagal ginjal kronis bisa nyebabake hiperaluminemia amarga jumlah aluminium sing cilik diserap saka saluran GI lan ekskresi aluminium. nyuda ing pasien kanthi gagal ginjal. Akumulasi aluminium ing CNS bisa dadi panyebab ensefalopati dialisis, dene akumulasi aluminium ing balung bisa nyebabake utawa ngrusak osteomalasia dialisis.
Kalsium Karbonat: Pasien kanthi gangguan ginjel utawa dehidrasi lan ketidakseimbangan elektrolit cenderung berkembang. sindrom susu-alkali. Risiko hiperkalsemia ing pasien hemodialisis kronis.
Antacid Magnesium: Ing pasien kanthi gangguan ginjel sing abot, hipermagnesemia sing ditondoi kanthi hipotensi, mual, muntah, owah-owahan ECG, depresi pernapasan utawa mental, lan koma. Aja diwènèhaké ing pasien gagal ginjel, lan antacid sing ngemot luwih saka 50 mEq magnesium ing dosis saben dina sing disaranake kudu digunakake kanthi ati-ati lan mung ing pengawasan dokter sing kudu ngawasi elektrolit ing pasien sing nandhang penyakit ginjel.
Natrium Bikarbonat: Bisa nyebabake alkalosis metabolik ing pasien kanthi insufisiensi ginjel.
Efek Samsaya Awon
Kanthi administrasi sing dawa, konstipasi (umpamane, uyah aluminium, kalsium karbonat), diare (contone, uyah magnesium), distensi lambung/kembung (contone, natrium bikarbonat), lan hipersekresi lambung/rebound asam (contone, kalsium karbonat).
Apa obatan liyane bakal mengaruhi Antacids
Kabeh antacid duweni potensi bisa nambah utawa nyuda tingkat lan/utawa tingkat panyerepan obat oral sing diwènèhaké bebarengan kanthi ngganti wektu transit GI utawa kanthi ngiket utawa ngelat obat kasebut. Panliten in vitro nuduhake yen magnesium hidroksida utawa trisilikat duweni potensi paling gedhe kanggo naleni obat lan aluminium hidroksida lan kalsium karbonat minangka penengah.
Obat lan Pangan Spesifik
Obat
Interaksi
Komentar
Aspirin
Interaksi farmakokinetik (nambah panyerepan saka aspirin sing dilapisi buffer utawa enterik utawa konsentrasi salisilat getih sing mudhun)
Chlordiazepoxide
Kamungkinan nyuda penyerapan klodiazepoksida kanthi persiapan aluminium hidroksida lan magnesium
Diazepam
Kamungkinan panyerepan diazepam kanthi aluminium hidroksida
Digoxin
Kamungkinan panyerepan digoxin mudhun
Dosis spasi obat-obatan sing adoh saka jarak sing bisa
Indometasin
Mungkin indometasin mudhun panyerepan
Dosis spasi obat kanthi jarak sing adoh
Garam wesi
Mungkin nyuda penyerapan uyah wesi
Dosis spasi saka obat-obatan kasebut adoh banget
Isoniazid
Kamungkinan nyuda penyerapan isoniazid karo aluminium hidroksida
Administrasi isoniazid paling sethithik 1 jam sadurunge antacid sing ngandhut aluminium
Susu utawa panganan liyane sing ngandhut kalsium
Bisa sindrom susu-alkali kanthi administrasi kronis bikarbonat lan susu utawa kalsium
Naproxen
Kamungkinan panyerepan naproxen tambah karo natrium bikarbonat
Kamungkinan nyuda penyerapan naproxen kanthi magnesium oksida utawa aluminium hidroksida
Pseudoephedrine
Kamungkinan panyerepan pseudoephedrine tambah karo aluminium hidroksida
Tetracyclines
Kamungkinan nyerep tetrasiklin mudhun
Ingake wektu 1-2 jam antarane dosis antasida lan tetrasiklin
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