Pharmacy Clinic
Treatment of Heart Burn

I-        Antacids

Classifications of anti acids:

A-Systemic anti acids (absorbed), e.g Na-bicarbonate which act very rapidly and relief pain by the effect only of a
single dose, but it has a short duration of action and it’s effect is followed by reflex increase in acid secretion , as well
as when absorbed it causes alkalosis in blood and in urea, and also cause release of CO2 and belching as side effect,
oedema produced due to sodium and heart failure in patients with cardiac and renal disease.
B-Non systemic anti acid e.g. all anti acids other than NaHCo3.
C-According to their effect on the intestine (constipating group and purgative group).
D-Alkaline salt’s e.g colloidal anti acids.

Drugs of anti acids:

-Mg-oxide and hydroxide has moderate effect but cause diarrhea, it is poorly absorbed and has no systemic effect.

-Ca-carbonate and hydroxide act somewhat rapidly and produce constipation; it can be absorbed by the circulation.

Note: Ca-groups are contraindicated with milk because they cause complex called milk alkaline syndrome(leading to
anorexia, headache, abdominal distress).
-AL-Hydroxide has slow effect and precipitate pepsin enzyme, cause constipation and contraindicated with tetracycline.
-Bismuth salt weak anti acid but has the ability to form coating around ulcer area.

Alginate: a raft is formed which sits on the surface of the stomach contents and prevents reflux. Some alginate based
products are rich in sodium bicarbonate. The function of sod. Bicarbonate in addition to its antacid action, is to cause
the release of carbon dioxide gas in the stomach, enabling the raft to float on top of the stomach contents. If
preparation low in sodium required, pharmacist can recommend a preparation containing potassium bicarbonate
instead. This useful for heartburn in pregnancy, and in hypertensive patients.




HEARTBURN
Tips for the treatment  
• Immediately drink a large glass of water. This will help wash the HCl back down and dilute it as well.
• Drink some raw potato juice. Whiz up an unpeeled potato and drink it down.
• Do not lie down. Remain upright, so gravity can help push the HCl down and keep it down. Later, when you do lie
down, elevate the bed at the foot by 4 inches.
• Avoid bending over; if you must lift something, bend at the knees. You do not want to compress your stomach
when you have heartburn.
• Eating mints relaxes the lower esophageal sphincter, so HCl can crowd up into the esophagus.
• Do not drink anything caffeinated, for it will irritate the esophagus even more. Caffeine relaxes the sphincter, so
stomach contents can move on up. Tobacco smoke also relaxes the sphincter. Estrogens relax it also.
• Drinking milk may feel good going down, but it encourages the stomach to secrete more acid.
• Drinks with fizz in them expand the stomach and make it more likely that HCl will come up the food pipe.
• Greasy, fried, and fatty foods sit in the stomach for a long time and increase HCl production. Avoid meat and dairy
products.
• Antidepressants and sedatives aggravate heartburn. Aspirin and ibuprofen cause heartburn.
• Antacids only mask the symptoms. They also contain aluminum.
• Avoid stress, for that increases HCl production also.
• Loosen your belt; better yet, wear suspenders.
• Do not eat within 2½ hours before bedtime. Doing so not only can cause heartburn, but bring on heart attacks also.
• Eat more raw vegetables, chew your food well, and eat slowly.