ABSTRACT
A 44-year-old patient was hospitalized with symptoms of abdominal pain and vomiting. No medications were mentioned during a medication
history at admission. Additional symptoms included drowsiness, dehydration, tachycardia (110 beats per minute) and hypertension (160/110mmHg). Abnormal laboratory values included elevated BUN (11.4 mmoYL), alkaline phosphatase (163 IU/L), creatinine (216 umol/L), amylase (3500 U/L), and corrected calcium (4.0 mmol/L). The patient was diagnosed with pancreatitis secondary to milk alkali syndrome. Although the patient initially denied medication use, a repeat medication history revealed the chronic use of nonprescription calcium-containing antacids for the last two to three years for osteoporosis prevention. Each antacid tablet contained 680 mg calcium carbonate. Approximate weekly intake averaged 70 tablets a week or 4.5 grams of calcium carbonate daily. Recovery was uneventful after therapy with lansoprazole (20 mg daily) was initiated. Post-discharge follow-up revealed electrolyte values that had returned to baseline levels.
