Understanding the Side Effects of Reducing Stomach Acid — Transcript

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1. 0:03simetidine and famotidine are histamine
2. 0:07II antagonists that decrease stomach
3. 0:09acidity
4. 0:10they're both in the top 200 most
5. 0:13prescribed medications
6. 0:14the main use of famotidine is in the
7. 0:18treatment of peptic ulcer disease and
8. 0:21also gastroesophageal reflux disease and
9. 0:24in conditions where there's just too
10. 0:27much acid in the stomach
11. 0:30this is normally the time that we'd be
12. 0:32investigating some of those safety
13. 0:34issues associated with those disorders
14. 0:36themselves the disorder is that the drug
15. 0:39Treats but we've already spoken about
16. 0:41some of these safety issues as we got a
17. 0:44good picture of the antacids and we'll
18. 0:48discuss them in depth next chapter as we
19. 0:51discuss the proton pump inhibitors so I
20. 0:54don't want to double up too much the
21. 0:56proton pump inhibitors are the first
22. 0:58line therapy for those disorders so it's
23. 1:00most appropriate that we speak of them
24. 1:02at that time
25. 1:04and while the proton pump inhibitors
26. 1:07like Omeprazole are the most effective
27. 1:11medications for reducing stomach acid
28. 1:14famotidine and other histamine 2
29. 1:17receptor blockers do reduce stomach acid
30. 1:20fairly well
31. 1:22and that is why it's a good time to try
32. 1:25to get some insight into the types of
33. 1:28side effects that would be possible when
34. 1:31you greatly reduce the stomach acid over
35. 1:34a long period of time
36. 1:36let's review the functions of the acid
37. 1:38in the stomach and try to predict the
38. 1:42side effects that are possible from
39. 1:44reducing that acid
40. 1:47the acid in the stomach probably has
41. 1:49more functions than you thought for
42. 1:51instance the acid begins to degrade many
43. 1:54of the foodstuffs it helps the
44. 1:56absorption of some nutrients it
45. 1:59decreases microorganisms and aside from
46. 2:03all that as we said before the stomach
47. 2:05acid is needed to help the absorption of
48. 2:08many of our drugs
49. 2:09so from that I'd like you to predict
50. 2:12some of the side effects that you would
51. 2:15expect to be possible as one
52. 2:17substantially decreases the stomach acid
53. 2:23we said the acid in the stomach helps
54. 2:26absorption of some nutrients it helps
55. 2:28decrease bacteria that are ingested also
56. 2:32helps decrease the proliferation of
57. 2:34bacteria in the stomach and it helps
58. 2:37absorption of some drugs so using that
59. 2:40information I'd like you to make a
60. 2:42hypothesis about the side effects that
61. 2:44you'd expect to be possible in people
62. 2:46taking the histamine II receptor
63. 2:49blockers
64. 2:52and you'd be correct if you had said
65. 2:54that the histamine two antagonists or
66. 2:56blockers will decrease the absorption of
67. 2:59some nutrients will increase
68. 3:01gastrointestinal tract infection risk
69. 3:04and alter the absorption of some drugs
70. 3:09there are at least three nutrients that
71. 3:12depend on the acidic environment of the
72. 3:14gastrointestinal tract including calcium
73. 3:17magnesium and vitamin B12
74. 3:20this is really important especially in
75. 3:23respect to vitamin B12 and the elderly
76. 3:26individuals normally our ability to
77. 3:29absorb vitamin B12 decreases as we age
78. 3:33and deficiencies in vitamin B12 can
79. 3:37cause a type of dementia so monitoring
80. 3:40the vitamin B12 levels is suggested if
81. 3:44the medication is expected to be
82. 3:46administered over months
83. 3:49the other thing about the nutrients
84. 3:51affected is the fact that both calcium
85. 3:54and magnesium are necessary in bone
86. 3:57health so decreasing stomach acids for
87. 4:00long periods of time without
88. 4:02supplementing those nutrients can
89. 4:05adversely affect bone health
90. 4:08as far as the increase in infections
91. 4:10interestingly enough the H2 blockers as
92. 4:14well as the proton pump inhibitors which
93. 4:16we'll talk about next chapter are
94. 4:19associated with an increase in git
95. 4:22infections and also an increase in
96. 4:27respiratory tract infections
97. 4:30the absorption of many drugs is also
98. 4:32affected by histamine 2 blockers because
99. 4:35medications are made for an acidic
100. 4:38environment in the stomach
101. 4:40and some side effects that you probably
102. 4:43didn't predict include an increased
103. 4:46incidence of food allergies probably
104. 4:49because the proteins the antigens on the
105. 4:52food are not being broken down well
106. 4:55enough
107. 4:56and finally there is a slight risk of
108. 4:58developing a faster or altered heartbeat