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  1. Read the text and answer the following questions.

  1. When are antacids used?

  2. What is gastric reflux?

  3. How to achieve normal tone of the sphincter muscle that separates the oesophagus from the stomach?

  4. What antacids are called non-systemic ones? How do they act?

  5. What antacids are called systemic ones? How do they act?

  6. When is sodium bicarbonate used?

Antacids

Antacids are used:

to relieve stom­ach pain and dis­comfort by neutral­izing the acidic gas­tric juices

In patients with excessive secretion of gastric hydro­chloric acid this reduces the effect of gastric juices on lesions in the stomach

to relieve pain and discomfort caused when stom­ach contents flow back into the oeso­phagus, and cause inflammation of the oesophageal wall

Gastric reflux is caused by a reduction in the tone of the sphincter muscle that separates the esophagus from the stomach. Effective tone is normally main­tained when the sphincter is in the normal closed state as increased intraabdominal pressure produces an increase in tone.

Decreased peristaltic movements slow the transit time of food through the oesophagus or stomach

aluminum com­pounds absorb and excrete phosphates from the alimentary tract

This prevents and treats hyperphosphataemia when the normal excretory pathways of phosphates are not functioning, e.g. renal failure.

Also useful in patients with a predisposition to form phosphate urinary calculi

Antacids used to neutralize the effects of gastric secretions are non-systemic, i.e. they are not absorbed into the blood circulation. These antacids are selected for their specific action in the stomach. Small amounts of antacid compound may be absorbed but this is not significant to their main purpose. Non-systemic compounds are usu­ally based on aluminum, magnesium or calcium.

Sodium bicarbonate is a systemic antacid; it is absorbed into the blood circulation. Following absorption, the antacid effect of sodium bicarbonate will interfere with the acid-base balance of the body. It j will cause a rise in body pH. Normally, respiratory and renal compen- | satory mechanisms will return the body pH to normal.

If disease produces a metabolic acidosis, sodium bicarbonate can be used to correct the pH balance of the body. Sodium bicarbonate should not be used to ease gastric symptoms.

[ 3 | Read the text and translate it into Ukrainian. Then tell your groupmates

about proton pump inhibiting drugs and their side effects.

Proton Pump Inhibitors Lansoprazole, Omeprazole

The production and secretion of gastric acid depends on the en­zyme H',Kl-ATPase. This proton pump powers the cell pathways that metabolise acid in the parietal cells of the stomach mucosa. Proton pump inhibiting drugs block this function irreversibly. Synthesis of I new supplies of the enzyme will be needed before gastric acid produc­tion returns to normal volume. This will occur a few days after a completed course of treatment.

Side effects of these drugs are rare but they may include gastric upsets, headache, and rashes and defects of the skin. Long-term thera­py may carry the risk of gastric cancer.

These drugs are metabolised for excretion by the liver, so liver func­tion should be assessed prior to prescribing proton pump inhibitors.

Omeprazole should not be given to pregnant or breast-feeding women.

Lansoprazole should be taken each morning. Antacids, if taken within 1 h of this drug, will reduce its effect.

1KXT 3

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