So let me explain how I came to the op. The PPH (specifically in the SN method to me is seemingly designed for those with physical ailments and are not on a cocktail of drugs to assist with their MH issues. A lot of posts here show quite rightly individuals looking at the regimen and highlight concerns with regard to adverse effects with their ongoing treatment. Especially in the areas of meto and acid regulators. In the past I came up with a crazy idea or two on how to get the SN into your system, and then my further research discounted them. So this is the approach I took to how the oral intake of SN could be done specifically for that profile of person. I got a clean piece of paper and started to track (with 100% help from the internet) the journey of SN from the mouth to the point SN entered the blood stream and all the metabolic processes that the body employs to remove toxins. Also the effect that SN has on our physiology to see if anything can enhance the process in either speed or efficiency. Doing that, I then cross referenced the PPH suggested regimen to understand what component works for what part of the digestive process. Hopefully some people would have noticed that through my research I said that SN is not a practical solution for those that suffer ulcers anywhere in their digestive tract based on this research. That is not in the PPH!
So I am going to go through the 'Sesame Street' version of human digestion so you get closer to why I suggested the above. So you drink the SN, it hits your mouth, nothing there to be seen or done for digestion. Goes down the gullet, meets a sphincter that controls both the entry of food into the stomach and stops gastric juices coming up which will give pain if allowed to do so. Then it hits the stomach. The stomach itself does nothing to send nutrients into the bloodstream. Its a big grinding machine that infuses the 'food' with enzymes and acid to help break down the food into a mush before the sphincter at the bottom end of your stomach allows passage into the small intestine.
Ok - so what is this gastric juices? Well there are a lot of enzymes and this thing called Hydrochloric Acid. A chemical! Interesting! What does that mean? Chemical formula for SN meeting your gastric juices would be 3NaNO2 + 2HCl → 2NaCl + NaNO3 + 2NO + H2O. Still lost me! Can you speak English please? So basically, when SN hits your stomach, the acid there works to convert it into other things such as regular table salt, Nitric oxide, Sodium Nitrate and water. None of those are really what you want. So reducing the HCL prevents SN being converted to something else? Yes, correct. Well how do we minimise this? It needs something to neutralise the HCL acid. More commonly you want to create a chemical reaction like this, Mg(OH)2(s) + 2HCl(aq) → 2H2O(l) + MgCl2(aq). You are at it again Stan! Speak English damn you! OK - what you need is an antacid with magnesium hydroxide in it. Why do you recommend that one over others? Well there are a number of other alkali that neutralise stomach acid, but this is the most benign on the list and has minimal to no conflict with other medications. It is generally known as Milk of Magnesia. Where do you find that? Any regular pharmacy without prescription. Can I use other non prescription antacid? Yes you can, I just stated Milk of Magnesia as it was the easiest when looking at some other drug interactions. But most are simple and cause no adverse effects.
So the SN is in our stomach, but you said that's not the place where the SN moves into the bloodstream. That's correct! Two main sphincters in the stomach, the one at the top already addressed and the one at the bottom which controls the movement into the small intestine where the nutrients (or SN in this case) transfers (and I am over simplifying this) into the bloodstream. Ah! So using meto is vital because it moves things faster into the small intestine? No! If you think that the reason Meto exists is for people who have conditions such as Gastroparesis where they cannot pass food very well. The key word here is food. What we are doing if we have followed the fasting process is give the stomach water. Yes, the SN is suspended in water but the stomach isn't a complex lab where it tests everything before it passes it through. But it does recognises two things. One that it is water and the body craves hydration so it will give that substance a priority pass to move to the small intestine. Secondly, the stomach does not need to mash it up to make it easier for the small intestine to cope with.
So what does that mean in conclusion? This is up for your debate and I take no offence in challenges, rebukes or proof that it is wrong. After all, this is a resource to help everyone pass peacefully with minimum stress and discomfort. Remember my premise for investigating this was that people understood that some of the regimen drugs recommended where in conflict with their existing prescription. Plus my personal opinion that the PPH has over-baked the regimen to reach the end goal (preparing yourself physically to ingest the SN).
Regimen DrugObjective of DrugAlternative viewMetoclopramideantiemetic
Moves food quicker into small intestineIf you have followed the fast. The natural human digestive process will move the liquid quickly into the small intestine to help the body hydrate.
With this fact out of the way, you could then look for an antiemetic that does not conflict with your existing meds (as long as it it the right type)RanitidineReduce stomach acid over a period of timeA drug that will reduce stomach acid but may also have serious interactions with other meds. The goal is to reduce the HCL in the stomach and the same goal can be reached by taking a stat dose of Milk of magnesia.