Medicines

Nowadays, a large number of drugs are used to treat intestinal diseases; in addition, every year the pharmaceutical industry offers one or two dozen new medications. Therefore, in my opinion, it is inappropriate to describe any specific drug. In addition, the choice and prescription of a drug is the task and prerogative of the doctor.

It seems to me necessary to talk about the rules for taking medications prescribed orally.

Have you ever wondered what happens after you take a drug? When taking medications orally, before they begin to act, they enter the gastrointestinal tract, in which, as you know, microorganisms live, gastric and intestinal juices are produced, food components and products of their digestion are found, etc. All this can change the structure of the drug taken; influence the effectiveness of therapy by increasing or decreasing it; lead to the development of undesirable (side) effects of treatment.

The most aggressive factor in the gastrointestinal tract in this regard is gastric juice. It contains enzymes that destroy many medicinal substances. It also contains hydrochloric acid, due to which gastric juice becomes acidic. An increase in the production of hydrochloric acid by the cells of the stomach leads to an increase in the absorption of medicinal substances that are acids in nature (acetylsalicylic acid (aspirin), phenobarbital, furosemide, etc.). The absorption of drugs that are bases (codeine, caffeine, etc.), under these conditions, on the contrary, is reduced.

Changes in the acidity of gastric juice are cyclical and depend on food intake, its properties, and regularity of nutrition (see Diagram 1). Usually on an empty stomach the production of hydrochloric acid is insignificant and gastric juice is slightly acidic. Eating leads to stimulation of hydrochloric acid production, and a change (increased secretion) is noted already 10-20 minutes before eating, which is subjectively perceived as a feeling of hunger. Food components, especially milk, meat, eggs, gradually reduce acidity, neutralizing hydrochloric acid. After this, with the gradual evacuation of food from the stomach to other parts of the gastrointestinal tract, gastric juice again becomes more acidic. Only 3-4 hours after eating, the acidity of gastric juice reaches the same value as on an empty stomach.

It would seem that medicinal substances that are acids, based on the data presented, should be taken at the beginning of a meal or 2 hours after a meal, and medicinal substances that are alkalis should be taken on an empty stomach or immediately after a meal. However, some drugs, such as erythromycin, tetracycline, sulfadimethoxine, captopril, can interact with food components. Other drugs, such as acetylsalicylic acid (aspirin), have an irritating effect on the gastric mucosa, which, if taken for a long time, can lead to inflammation (gastritis) and even ulcers. Drugs such as, for example, drotaverine (no-spa), although they do not interact with food and do not irritate the stomach wall, can negatively affect the digestive processes. Therefore, in cases where this is not specifically stated, medications are taken on an empty stomach. This technique allows you to minimize the interaction of drugs and food components.

Use on an empty stomach is considered to be taking medications at least 30 minutes before meals (with regular meals) or 4 hours after meals. Acid-resistant medications and digestive enzymes are taken with meals. After meals, they take medications that irritate the gastric mucosa.

Chew - don't chew. In order for medications to be absorbed in the intestines and begin to have an effect on the body, they must be dissolved in the juices produced by the gastrointestinal tract. Preliminary