Antacids

Antacids are used for inflammation of the stomach and abdominal discomfort. It may be associated with feelings of fullness, bloating and flatulence (gas). TUMS or calcium carbonate is very effective as an antacid however it can cause "acid rebound" and constipation. It is also commonly given as a calcium supplement to prevent osteoporosis.

Aluminum antacids neutralize acids the best, however they are limited by their propensity to cause constipation. Patients with chronic renal failure should not be take these antacids because they can cause nervous system toxicity. To avoid the constipating effects, aluminum can be combined with magnesium. Examples of these products include Mylanta and Maalox. Magnesium only antacids should be avoided due to its diarrhea inducing effect.

H-2 blockers

Histamine 2 blockers are available by prescription or over-the-counter for dyspepsia, gastritis and heartburn. The over-the-counter doses are lower than those required by prescription. Over-the-counter H2 blockers include cimetidine (Tagamet™), ranitidine (Zantac™), famotidine (Pepcid™) and nizatidine (Axid™). Of all of these, cimetidine has the potential for causing the most confusion and drug interactions in older patients. Cimetidine decreases the clearance of many drugs that are metabolized by the liver and should not be taken by older adults unless absolutely necessary.

Prescriptive strength H2 blockers are indicated for peptic ulcer disease, gastritis, and heartburn. These drugs must be adjusted for any decreased kidney function. Common prescription medications used to treat gastrointestinal disorders include Prilosec™ and Carafate™. Adverse effects of Carafate™ include constipation and gastric discomfort. Carafate™ should be used cautiously by persons who have chronic renal failure due to aluminum toxicity.