If prepared in accordance with the method of the British Pharmacopoeia Magnesium Trisilicate Mixture is composed of the active ingredients magnesium trisilicate, light magnesium carbonate, and sodium bicarbonate, with peppermint oil and chloroform as flavouring substances. The insoluble magnesium compounds are suspended in the aqueous vehicle and, as a criterion of quality, these magnesium substances form almost half the volume of this liquid product upon allowing to rest undisturbed for a sufficient time.
Magnesium Trisilicate Mixture is used in therapeutics as an antacid. Its pharmacological action is biphasic, exhibiting a time course of an immediate action coupled with a long term and residual action.
Its immediate action
The dissolved bicarbonate ions mop up preexisting gastric acid in keeping with the following chemical reaction;
A therapeutic response based on this pharmacological action manifests within a few minutes subsequent to oral administration and because of this action the use of parenteral proton-pump inhibitor in a non-emergency situation may not be necessary.
Residual action
Both magnesium carbonate and magnesium trisilicate neutralizes excess gastric acid in a slow running chemical reaction that can span over several hours. In the case of the latter, reaction with gastric acid splits the complex compound producing silicic acid and magnesium oxide. The silicic acid formed, otherwise known as hydrated silica or colloidal silica, has a very fine texture with particle sizes within the nanometer scale range. Colloidal silica is known to bind tenaciously to proteins, hence the theory that that produced in situ from the hydrolysis of magnesium trisilicate binds to ulcerated lesions located within the lumen of the gastrointestinal tract. The commonly accepted theory is that Magnesium Trisilicate Mixture additionally acts by forming a protective coat of colloidal silica over gastric and duodenal ulcers, this colloidal silica layer proving an effective mechanical barrier against contact of these ulcer lesions with gastric acid. This is what has been described as the long term and residual action of Magnesium Trisilicate Mixture.
Administration
The usually recommended adult dose of Magnesium Trisilicate Mixture is 10 - 20mL, repeated three times a day or as required. As a practice, each dose should be mixed with a small quantity of water to increase its bulk.
Magnesium Trisilicate Mixture is prescribed for treatment in various options. In a popular treatment option touted as the Fordtran regimen Magnesium Trisilicate Mixture may be administered four times within a day; three times within the day, preferably between 1 - 2 hours after a meal, and the last dose taken at bedtime. This regimen may suffice for treatment of peptic ulcer and dyspeptic ailments as monotherapy. In current practice the proton-pump inhibitors have supplanted antacids from the enviable place they once held and have lessened their importance in the treatment of peptic ulcer and other dyspeptic ailments. Now, Magnesium Trisilicate Mixture may still be added to a proton-pump inhibitor to achieve synergistic effect according to the mechanisms already discussed, albeit the frequency of its administration will have to be reduced dramatically.
The most controversial treatment option is when Magnesium Trisilicate Mixture, or any other antacid, is added to a triple therapy regimen for treatment of confirmed cases of peptic ulcer disease. Otherwise, the concurrent usage of a proton-pump inhibitor with Magnesium Trisilicate Mixture, or another antacid, is very reasonable and may even allow less frequent administration of both drugs.
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