- ياترى مكملات الكالسيوم رفاهية ولا ضرورة؟
- السوق مليان مكملات كالسيوم... انهي نوع هيبقا مناسب ؟؟؟🤔
- وهل الناس الي ماشية على أدوية المعدة ينفع معاهم اي نوع كالسيوم؟؟؟❓❓❓
صراع بين ال CAL-MAG و CONTORLOC؟؟؟ ⚠️⚠️
يلا بينا نعرف الكلام ده Let's go 💪
Firstly what are PPIs??
Proton pump inhibitors.... ( their generic name contains suffix - prazole )
They reduce the production of protons in the stomach so reducing its acidity which help in protecting the lining of gut from ulcers.
((PPI can stop the production of stomach acid completely after 4 days of continuous using))
Indications:
1) GERD patients.
2) PPI is a main drug in the treatment of H-pylori.
3) prevention of NSAIDs - induced ulcers.
4) generally used as a protective agent from any drug - induced ulcers. Like : oral glucocorticoids, SSRIs, anticoagulants.
✳️As we see PPIs are very common drugs...and many patients depend on them for long term regimen.
ولكن للأسف الشديد مفيش حاجه حلوة بتكمل للآخر 🙄
✳️it's important to know that the patient who use PPI for long term is at very high risk of developing osteoporosis as Calcium and Magnesium needs acidic medium to be absorbed so Ca & Mg are poorly absorbed while using PPI.
✳️Therefore the patient should take Ca supplements (Ca citrates **
😁 خد بالك من ديه)
- هل ياترى دي كل الحالات الي المريض بيبقا عرضة لهشاشة العظام ؟؟ 🤔
Definitely not , there're many other common cases like :
1) postmenopausal women
2) vegetarians or poor people who don't get enough Ca daily intake.
3) people with lactose intolerance.
4) people on long term regimen of steriods (autoimmune diseases' patients).
-تخيل بقا معايا عزيزي الصيدلي يبقا فيه حالة زي الي هنقولها كده عندها كل العوامل الي تخليها يجيلها هشاشة...
(postmenopausal 55 years old female(1) receives the following medications daily : 20mg predinisolone(2) to manage her autoimmune disease and 40mg pantoprazol(3) to manage the side effects of steroids).
- زي ما انت شايف حالة زي ديه عندها بدل السبب تلاته يجبلها هشاشة عظام 😅...
✳️So we conclude that Ca supplements are essential in many cases.
But which type of Ca supplement is suitable? 🤔
❓❓❓❓❓❓
- Ca supplements are manufactured majorly in form of two salts (( Ca carbonate, Ca citrate ))
ايه الفرق ياترى ؟
1️⃣Ca carbonate salt needs acidic medium to be absorbed so it should ONLY be taken with food .
الملح ده بيفرق معاه الحمضية 😏
While Ca citrate salt isn't affected by the acidity of stomach therefore it can be well absorbed in low acidic pH as in empty stomach or in case of using ppi/antacid.
الملح ده مبيفرقش معاه الحمضية 😉
✳️So now we understand the reason of choosing CAL-MAG specifically for patients taking PPIs as it is the only market product that contains Ca citrate salt.
2️⃣Ca carbonate contains much higher conc. of elemental calcium ( 40% of its weight is Ca), while Ca citrate contains only 21 % elemental Ca.
✳️So it's obvious that when it comes to the option which gives more Ca and the option that needs fewer tablets to meet the RDA, carbonate salt is the best choice.
3️⃣ Ca carbonate cause some digestive issues like constipation and bloating while Ca citrate nearly doesn't.
4️⃣ Products of Ca carbonate is cheaper than those of ca citrate.
✳️ 3️⃣ And 4️⃣ are important for patient compliance so it should be considered.
اهم حاجة المريض يكمل عليه فلازم يبقا مناسب لميزانيته وميبقاش بيتعبه 👌
So finally the suitable Ca supplement for the patient who uses PPI is that contains Ca citrate salt. e.g : CAL-MAG®
and the ones who don't use PPIs it's preferred to use Ca carbonate supplements.
e.g : Osteocare®
الي هنا نكون قد انتهينا من اهم المعلومات اللي ممكن تقابلك في الصيدلية ⚕️