Interaction of liquid aluminium phosphate and aluminium hydroxide with the gastric acid profile. Influence of food components and timing of meals.
AlPO4 is generally perceived as a particularly weak antacid. Its neutralizing capacity, when evaluated with the classical Fordtran test at the pH 3 standard, is several times smaller than that of Al(OH)3, which is considered a particularly potent antacid. This difference of in vitro reactivity of the two antacids is largely due to the fact that the pKa value is considerably lower for AlPO4 than for Al(OH)3. The object of this study was to evaluate in vivo and in vitro the impact of the pKa value of these antacids on their efficacy at low pH values and the modulation of their neutralizing capacity through proteins. Since both preparations display a much closer antacid activity at pH 2, we felt it appropriate to reevaluate the comparative in vivo neutralizing capacity of the two antacids at doses matched with their in vitro reactivity at pH 2. In vivo antacid effects were measured by ambulant pH-metry in 18 healthy volunteers after randomized ingestion of carbohydrate or protein meals. Antacid or placebo medication was given 1 and 3 h after meals. At pH 3.0, the standard milieu of the Fordtran test, preparation A, composed of Al(OH)3 and a small fraction of Mg(OH)2, displayed in vitro a neutralizing capacity of 4.4 mmol/ml, whereas this was 0.18 mmol/ml for preparation B, composed solely of AlPO4 (p less than 0.001). When tested at pH 1, 1.5, and 2, however, the ratio between A and B was below 2.(ABSTRACT TRUNCATED AT 250 WORDS)
Schürer-Maly
C C
CC
Gastrointestinal Unit, University Hospital, Inselspital Bern, Switzerland.
Varga
L
L
Halter
F
F
D000328:Adult; D000535:Aluminum / Q000494:pharmacology*; D017607:Aluminum Compounds; D000536:Aluminum Hydroxide / Q000494:pharmacology*; D000863:Antacids / Q000494:pharmacology*; D002940:Circadian Rhythm / Q000502:physiology; D004040:Dietary Carbohydrates / Q000494:pharmacology; D004044:Dietary Proteins / Q000494:pharmacology; D005260:Female; D005502:Food; D005744:Gastric Acid / Q000378:metabolism*; D005745:Gastric Acidity Determination; D006801:Humans; D006863:Hydrogen-Ion Concentration; D066298:In Vitro Techniques; D008297:Male; D008991:Monitoring, Physiologic / Q000379:methods; D010710:Phosphates / Q000494:pharmacology*
D017607:Aluminum Compounds; D000863:Antacids; D004040:Dietary Carbohydrates; D004044:Dietary Proteins; D010710:Phosphates; D000536:Aluminum Hydroxide; D000535:Aluminum; C012714:aluminum phosphate