Antacid

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Antacid tablets

An antacid is a substance which neutralizes stomach acidity, which in turn relieves heartburn, indigestion or stomach upset.[1]

Medical uses[edit]

Antacids are available over the counter and are taken by mouth to quickly relieve occasional heartburn, the major symptom of gastroesophageal reflux disease and also indigestion. Treatment with antacids alone is symptomatic and only justified for minor symptoms.[2]

Antacids are distinct from acid-reducing drugs like H2-receptor antagonists or proton pump inhibitors and they do not kill the bacteria Helicobacter pylori, which causes most ulcers.[2]

Side effects[edit]

Versions with magnesium may cause diarrhoea, and brands with calcium or aluminium may cause constipation and rarely, long-term use may cause kidney stones. Long-term use of versions with aluminium may increase the risk for getting osteoporosis.[3]

Mechanism of action[edit]

When excessive amounts of acids are produced in the stomach the natural mucous barrier that protects the lining of the stomach can damage the esophagus in people with acid reflux. Antacids contain alkaline ions that chemically neutralize stomach gastric acid, reducing damage and relieving pain.[1]

Formulations and brands[edit]

Antacids may be formulated with other active ingredients such as simethicone to control gas or alginic acid to act as a physical barrier to acid.[4]

Eno[edit]

Eno-logo.png

Eno is an antacid brand whose main ingredients are sodium bicarbonate, sodium carbonate, and citric acid; it is sometimes used as baking powder.[5][6] Eno was first marketed by James Crossley Eno (1827–1915).[7] The legend says that his idea for the product arose while he was working at the pharmacy of an infirmary in Newcastle where Dennis Embleton worked, and that Embleton often prescribed an effervescent drink made by mixing sodium bicarbonate and citric acid in water, and that Eno adopted this beverage from Embleton.[8] However, Eno opened a pharmacy where he made the mixture in 1852, a year before Embleton came to work at the infirmary, and such fruit salt mixtures were common at the time.[8] Eno gave away his branded mixture to sea captains at the port, and in this way Eno's became a brand known around the world; by 1865 he had to move to a bigger facility, and he formally founded the company Eno's "Fruit Salt" Works in 1868.[8][9][10]:253 In 1878 Eno moved the business to Hatcham where the factory employed 50 people by 1884.[11]

Eno was advertised heavily, like all patent medicines were at that time.[8] In 1883 it was advertised as a cure for cholera[12] and in 1892 for "keeping blood pure and free from disease", prevention of diarrhea, and many other conditions.[13] By 1928 the company had factories in England, Canada, France, Germany, Spain, and the US; that year the company was acquired by International Proprietaries, a company that had been established by Canadian businessman Harold F. Ritchie.[10]:253 International Proprietaries was eventually renamed Eno, and in 1938 the business was bought by Beecham[10]:253 for its products as well as its international marketing force.[14] As the pharmaceutical industry transitioned from selling cure-all patent medicines to selling drugs in the 1950s, Eno was one of a handful of products that were retained in the industry.[15]:154

Algeldrate[edit]

Wyeth amphojel tablets of aluminum hydroxide.

Under the generic name algeldrate, aluminium hydroxide is used as an antacid. Aluminium hydroxide is preferred over other alternatives such as sodium bicarbonate because Al(OH)3, being insoluble, does not increase the pH of stomach above 7 and hence, does not trigger secretion of excess acid by the stomach. Brand names include Alu-Cap, Aludrox, Gaviscon or Pepsamar. It reacts with excess acid in the stomach, reducing the acidity of the stomach content,[16] which may relieve the symptoms of ulcers, heartburn or dyspepsia. Such products can cause constipation, because the aluminum ions inhibit the contractions of smooth muscle cells in the gastrointestinal tract, slowing peristalsis and lengthening the time needed for stool to pass through the colon.[17] Some such products (such as Maalox) are formulated to minimize such effects through the inclusion of equal concentrations of magnesium hydroxide or magnesium carbonate, which have counterbalancing laxative effects.

References[edit]

  1. ^ a b Internal Clinical Guidelines Team (UK). Dyspepsia and Gastro-Oesophageal Reflux Disease: Investigation and Management of Dyspepsia, Symptoms Suggestive of Gastro-Oesophageal Reflux Disease, or Both. London: National Institute for Health and Care Excellence (UK); 2014 Sep. PMID 25340236. Free full text
  2. ^ a b U.S. Department of Health & Human Services. Agency for Healthcare Research and Quality 23 September 2011 Consumer Summary – Treatment Options for GERD or Acid Reflux Disease: A Review of the Research for Adults
  3. ^ U.S. Department of Health and Human Services, National Institutes of Health, U.S. National Library of Medicine. Page last updated: 07 November 2014 Medline Plus: Taking Antacids
  4. ^ IFFGD. Antacids Adapted from IFFGD Publication #520 by W. Grant Thompson. Last modified on September 12, 2014
  5. ^ "Eno's Fruit Salt". The Quack Doctor. 17 July 2009. 
  6. ^ "Eno - Summary of Product Characteristics at eMC". Electronic Medicines Compendium. Retrieved 2 September 2016. Last updated 1 January 2016 
  7. ^ "James Crossley Eno". Geni.
  8. ^ a b c d W. A. Campbell (June, 1966) James Crossley Eno and the Rise of the Health Salts Trade. University of Newcastle Upon Tyne Medical Gazette 60(3):350 Reprinted as an appendix to W. A. Campbell. The Analytical Chemist In Nineteenth Century English Social History Thesis presented for the degree of Master of Letters in the University of Durham. Newcastle upon Tyne July 1971
  9. ^ Russell, edited by Colin A. (1999). Chemistry, society and environment : a new history of the British chemical industry. Cambridge: Royal Society of Chemistry. p. 137. ISBN 9780854045990. 
  10. ^ a b c Wilkins, Mira (2004). The history of foreign investment in the United States, 1914-1945. Cambridge, Mass: Harvard University Press. ISBN 9780674045187. 
  11. ^ Dews, Nathan (1884). The History of Deptford (2nd ed.). Simpkin, Marshall, & Co. pp. 273–274. 
  12. ^ Kotar, S.L.; Gessler, J.E. (2014). Cholera a worldwide history. Jefferson, NC: McFarland. p. 242. ISBN 9781476613642. 
  13. ^ Advertisement for ENO. The Sunday Magazine, Collected issues of 1892. Strahan & Company, p 892. Quote: "Drawing an Overdraft on the Bank of Life. Late Hours, Fagged, Unnatural Excitement, Breathing Impure Air, too Rich Food, Alcoholic Drink, Gouty, Rheumatic, and other Blood Poisons, Fevers, Feverish Colds, Influenza, Sleeplessness, Biliousness, Sick Headache, Skin Eruptions, Pimples on the Face, Want of Appetite, Sourness of Stomach, etc. It prevents Diarrhoea, and removes it in the early stages. Use ENO's "FRUIT SALT" It is Pleasant, Cooling, Health-Giving, Refreshing, and Invigorating. You cannot overstate its great value in keeping the Blood Pure and free from Disease. TO ALL LEAVING HOME FOR A CHANGE. - Don't go without a bottle of ENO's "FRUIT SALT". It prevents any over-acid state of the blood. It should be kept in every bedroom, in readiness for any emergency. Be careful to avoid rash acidulated salines, and use ENO's "FRUIT SALT" to prevent the bile becoming too thick and (impure) producing a gummy, viscous, clammy stickiness or adhesiveness in the mucous membrane or the intestinal canal, frequently the pivot of diarrhoea and disease. ENO's "FRUIT SALT" prevents and removes diarrhoea in the early stages. Without such a simple precaution the jeopardy of life is immensely increased. There is no doubt that where it has been taken in the earliest stages of a disease it has in many instances prevented what would otherwise have been a severe illness."
  14. ^ Tedlow, Richard S.; Jones, Geoffrey G. (2014). The Rise and Fall of Mass Marketing (RLE Marketing) Volume 25 of Routledge Library Editions: Marketing. Routledge. pp. 110–111. ISBN 9781317663010. 
  15. ^ Crellin, John K. (2004). A social history of medicines in the twentieth century : to be taken three times a day (Reprint. ed.). New York: Pharmaceutical Products Press. ISBN 9780789018458. 
  16. ^ Galbraith, A; Bullock, S; Manias, E; Hunt, B.; Richards, A. (1999). Fundamentals of pharmacology: a text for nurses and health professionals. Harlow: Pearson. p. 482. 
  17. ^ Washington, Neena (2 August 1991). Antacids and Anti Reflux Agents. Boca Raton, FL: CRC Press. p. 10. ISBN 0-8493-5444-7. 
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