Drilldown: Medicines

Omeprazole (1) · Sodium bicarbonate (1)

Neut, many generic; OTC oral: Alka-Seltzer (with aspirin/citric acid), baking soda (1) · Prilosec, Losec, Zegerid (1)

[[:Category:Antacids|Antacid]] (1) · [[:Category:Antisecretory_agents|Gastric acid suppressant]] (1) · [[:Category:Electrolyte_replacements|Electrolyte replacement]] (1) · [[:Category:Proton_pump_inhibitors|Proton pump inhibitor (PPI)]] (1)

'"`UNIQ--vote-00000016-QINU`"' Bicarbonate is not benign: high-volume use produces hypernatremia, metabolic alkalosis, hypokalemia, and (in arrest) paradoxical intracellular acidosis'"`UNIQ--ref-00000017-QINU`"'. (1) · '"`UNIQ--vote-000000D8-QINU`"' Recovery of acid output requires synthesis of new pump enzyme. CYP2C19 substrate; PGx genotype substantially affects exposure and efficacy'"`UNIQ--ref-000000D9-QINU`"'. (1)

'"`UNIQ--vote-00000018-QINU`"', '"`UNIQ--vote-00000019-QINU`"', '"`UNIQ--vote-0000001A-QINU`"', '"`UNIQ--vote-0000001B-QINU`"', '"`UNIQ--vote-0000001C-QINU`"' (1) · '"`UNIQ--vote-000000DA-QINU`"', '"`UNIQ--vote-000000DB-QINU`"', '"`UNIQ--vote-000000DC-QINU`"', '"`UNIQ--vote-000000DD-QINU`"' (1)

20 mg PO once daily 30-60 minutes before breakfast (1) · IV: 1 mEq/kg bolus in arrest indication, then titrated to ABG and clinical status; PO: 325-2000 mg up to QID as antacid (1)

10, 20, 40 mg delayed-release capsules and tablets; 2 mg/mL oral suspension; immediate-release combo with sodium bicarbonate (Zegerid) (1) · 4.2%, 7.5%, 8.4% IV (1 mEq/mL at 8.4%); 325, 650 mg oral tablets; bulk powder (1)

40 mg/d typical; up to 360 mg/d for Zollinger-Ellison (1) · No fixed maximum; titrated to pH and bicarbonate level; chronic high oral doses cause metabolic alkalosis and volume overload (1)

IV (2) · Oral (2)

Immediate (IV); within minutes (oral antacid) (1) · Symptom relief 1-4 days; full acid suppression after 3-5 days of dosing (1)

24-72 hours per dose (irreversible enzyme binding; effect outlasts plasma exposure) (1) · IV: hours, dependent on ongoing acid load; oral antacid: ~30 minutes (1)

None · ~12 hours · ~27 days · ~5 h (caffeine) · '''Autoinduction''': 25-65 hours initially, falling to 12-17 hours after 2-3 weeks of dosing as carbamazepine induces its own CYP3A4 metabolism. Major clinical implication: doses require re-titration after the autoinduction period'"`UNIQ--ref-0000001D-QINU`"' · 0.5-1.5 hours (plasma); pharmacodynamic effect persists 24+ hours'"`UNIQ--ref-000000DE-QINU`"' · 1-1.3 hours'"`UNIQ--ref-000001A1-QINU`"' · 1-1.5 hours'"`UNIQ--ref-00000DE3-QINU`"' · 1-2 hours (parent compound)'"`UNIQ--ref-00000029-QINU`"' · 1-2 hours (parent); 18-30 hours for active metabolite oxypurinol'"`UNIQ--ref-0000030F-QINU`"' · 1-2 hours'"`UNIQ--ref-00000017-QINU`"' · 1-3 days acute, 4-6 days chronic; 4-16 days for norfluoxetine'"`UNIQ--ref-0000004C-QINU`"' · 1-3 hours (normal liver); markedly prolonged in overdose with glutathione depletion'"`UNIQ--ref-00000022-QINU`"' · 1-3 minutes (very short)'"`UNIQ--ref-00000C0F-QINU`"' · 1.4 hours (parent); 13-24 hours for active metabolite canrenone'"`UNIQ--ref-00000354-QINU`"' · 1.5-2 hours (longer in renal failure)'"`UNIQ--ref-00000222-QINU`"' · 1.5-2 hours'"`UNIQ--ref-00000020-QINU`"' · 10-11 hours (benazeprilat, the active metabolite)'"`UNIQ--ref-00000A22-QINU`"' · 11-13 h (immediate-release); 11-16 h (extended-release) · 11-15 hours'"`UNIQ--ref-00000842-QINU`"'

Other values:

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100% (IV); rapidly neutralized by gastric acid (oral) (1) · 30-40% (oral; increases with repeated dosing as gastric pH rises)'"`UNIQ--ref-000000DF-QINU`"' (1)

Routine antacid and acidosis correction acceptable (1) · Widely used in pregnancy; meta-analyses do not show increased malformation risk.<sup class="pcp-cn" title="This claim needs a citation.">&#91;[[Pharmacopedia:Citation needed|citation&nbsp;needed]]&#93;</sup> (1)

OTC (20 mg) and [[USLegal:Prescription only|Rx-only]] (higher doses) in US (1) · [[USLegal:Prescription only|Rx-only]] for IV formulations; OTC for oral (1)