Constipation, drug-induced

Calcium-channel blockers for the treatment of hypertension Calcium products Cephalosporins Cerebroactive medications Chlamydial infections treatment of Cholinergic drugs uses in medicine Cholinergic-receptor-blocking agents uses of Cirrhosis treatment of Congestive heart failure treatment of Constipation drug-induced Corticosteroids uses for Crohn s disease treatment of Cytokines their actions... 

Constipation Dehydration Drug induced (anticholinergics) Inactivity Low residue (fiber) content Obstruction/fecal impaction... 

Causes of drug-induced constipation are listed in Table 22-1. 

Excessive central stimulation, usually exhibited as tremors, insomnia and hyperhidrosis, can occur following therapeutic doses of the MAOIs, as can agitation and hypomanic episodes. Peripheral neuropathy, which is largely restricted to the hydrazine type of MAOI, is rare and has been attributed to a drug-induced p)n idoxine deficiency. Such side effects as dizziness and vertigo (presumably associated with hypotension), headache, inhibition of ejaculation (which is often also a problem with the TCAs), fatigue, dry mouth and constipation have also been reported. These side effects appear to be more frequently associated with phenelzine use. They are not associated with any antimuscarinic properties of the drug but presumably arise from the enhanced peripheral sympathetic activity which the MAOIs... 

The side effects of mycophenolate mofetil include diarrhea, abdominal pain, constipation, nausea/vomiting, acne, dyspnea, cough, peripheral edema, increased risk of infections, drug-induced fever, dizziness, headaches, leukopenia and anemia. 

A laxative would seem appropriate at this stage as Mr A is elderly and it is likely that his constipation is drug-induced. 

Drug-induced anorexia, nausea, vomiting, and constipation are common side effects. 

Causes of constipation in infants and children include functional constipation, neurogenic constipation [aganglionosis, hypoganglionosis, neuronal intestinal dysplasia (NID)], chronic intestinal pseudo-obstruction, disorders of the spinal cord, cerebral palsy, constipation secondary to anal fissures and strictures, neonatal hypothyroidism and drug induced constipation (Potter 1998). 

Cortex Dictamnus dasycarpus (bai xian pi) and Radix Sophora flavescens (ku shen), is commonly used to treat hematochezia, anal bulge, and constipation caused by hemorrhoids. The State Food and Drug Administration of China (SFDA) has received several reports of adverse reactions to Zhi xue capsule in recent years [7, 8 ]. Up to September 2008, 35 cases of adverse reactions associated with Zhi xue capsule had been reported, of which 21 were associated with abnormal liver function, cholestatic hepatitis, and drug-induced liver damage. After withdrawal and symptomatic treatment, there was full recovery in eight cases, and the rest improved markedly. 

Antimuscarinic drugs such as atropine have been used to modest effect in the treatment of PD for more than a century attenuating tremor and rigidity but with little effect on akinesia. Currently benzhexol and benztropine are sometimes added to levodopa therapy but peripheral effects such as dry mouth, blurred vision and constipation are unpleasant. They are also often used to counteract neuroleptic-induced extrapyramidal effects. 

The history of this class of analgesics might have stopped there were it not for the manifold ancillary activities shown by that molecule. Although still one of the most widely used agents for treatment of severe pain, morphine is a drug that must be used with caution. Side effects include respiratory depression, induction of constipation, and sometimes marked sedation. The one property that most severely limits use of this drug is its propensity to induce physical dependence in patients subjected to more than casual exposure. 

The major toxic reactions to disopyramide administration include hypotension, congestive heart failure, and conduction disturbances. These effects are the result of disopyramide s ability to depress myocardial contractility and myocardial conduction. Although disopyramide initially may produce ventricular tachyarrhythmias or ventricular fibrillation in some patients, the incidence of disopyramide-induced syncope in long-term therapy is not known. Most other toxic reactions (e.g., dry mouth, blurred vision, constipation) can be attributed to the anticholinergic properties of the drug. 

Meperidine differs from morphine in that it has far less antitussive effect and little constipative effect. The drug is particularly useful in cancer patients and in pulmonary patients, in whom the cough reflex must remain intact. However, it does have more seizure-inducing activity than morphine. Although meperidine produces spasms of the biliary tract and colon, such spasms are of shorter duration than those produced by morphine. 

Tricyclic antidepressants are still prescribed today, but some patients experience side effects such as dry mouth, blurry vision, constipation, and other uncomfortable conditions. Other antidepressants have since been found that induce fewer side effects. One of the most popular is fluoxetine, which is marketed under the trade name Prozac. This drug, along with Zoloft and other antidepressants, are known to inhibit reuptake proteins specifically for serotonin. As a result, these drugs are called selective serotonin reuptake inhibitors, or SSRIs. Although some concerns have appeared because of a possible risk of suicide in young patients who take Prozac, these drugs are commonly prescribed and have proved highly effective in millions of patients. 

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