Sucralfate

Sucralfate is a basic aluminum salt of sulfated sucrose. Its action is primarily local rather than systemic. In the acidic stomach, it changes into a viscous, adhesive paste that attaches to the ulcer base and shields the injured tissue from acid, pepsin, and bile salts. This is a temporary patch over damaged mucosa, not an acid-suppressing drug. Sucralfate does not work like a proton pump inhibitor or an H2-receptor antagonist, which reduce acid production throughout the stomach. Because sucralfate is only minimally absorbed, it produces its protective effect within the gastrointestinal tract; the small absorbed fraction is excreted in urine. For US-labeled use, sucralfate treats an active duodenal ulcer for up to 8 weeks and may be continued as maintenance therapy after healing to reduce recurrence. A prescription for another gastrointestinal condition requires the nurse to follow the specific indication and ordered plan rather than assuming that all ulcer diagnoses have the same approved use.