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Aluminum hydroxide is a medication used in the management and treatment of acid indigestion. It is in the antacid class of drugs. This activity outlines the indications, action, and contraindications for aluminum hydroxide as a valuable agent in the management of acid indigestion or topical burns. This activity will highlight the mechanism of action, adverse event profile, and other key factors (e.g., off-label uses, dosing, pharmacodynamics, pharmacokinetics, monitoring, relevant interactions) pertinent for members of the healthcare team in the treatment of patients with acid reflux and related conditions. Objectives: Identify the mechanism of action of aluminum hydroxide. Describe the adverse effects and contraindications of aluminum hydroxide. Review the toxicity of aluminum hydroxide. Outline interprofessional team strategies for improving care coordination and communication to appropriately direct outcomes for patients receiving aluminum hydroxide. Access free multiple choice questions on this topic.

Seizures, osteomalacia, and encephalopathy are well-documented toxic effects of aluminum hydroxide. Patients should be asked about any kidney issues before aluminum hydroxide administration, as these outcomes have strong correlations with aluminum hydroxide's use as a phosphate binder in patients on dialysis.[7] Most reports of encephalopathy and osteomalacia came from a period when water purification standards for dialysis were not as strong as they are now, likely confounding the relationship of oral aluminum to toxicity. Reversal of aluminum hydroxide toxicity occurs with the cessation of the drug. Topical aluminum hydroxide and aluminum hydroxide adjuvant vaccines have not shown to produce any toxic effects, primarily due to the small concentration associated with both applications.

Managing the administration of aluminum hydroxide as an antacid to patients requires an interprofessional team of healthcare professionals that includes a nurse, laboratory technologists, pharmacists, social workers, and several physicians in different specialties. After the diagnosis of an illness treatable with aluminum hydroxide, such as heartburn, is made, care is necessary to ascertain if the patient possesses any risk factors or contraindications to aluminum hydroxide. Recommendations for Increasing Successful Outcomes of Antacid Aluminum Hydroxide Therapy Discontinue administration of aluminum hydroxide in patients with renal impairment. Do not administer aluminum hydroxide concurrently with antimicrobials such as fluoroquinolones. Avoid the use of antacid treatment in patients taking medications that depend upon the acidic nature of the stomach for proper absorption. Prescribe aluminum hydroxide for temporary use rather than prolonged management Discontinue administration of aluminum hydroxide when used as an antacid if the patient develops severe diarrhea The clinician and nurses should monitor the patient and report untoward findings to the team. Pharmacists can also counsel the patient regarding dosing and the proper application of topical dose forms. The pharmacist should also check for drug interactions. Complications or issues with therapy should be reported to the medical team. All practitioners should be aware of the potential problems of long-term use, and counsel and direct the patient accordingly, particularly in those with renal compromise. Interprofessional monitoring of patients taking aluminum hydroxide will lead to better outcomes. [Level 5]