Diarrhea drug-related

Diarrhea Drug related Antibiotic-induced bacterial overgrowth Hyperosmolar medications administered via feeding tubes Antacids containing magnesium Malabsorption Hypoalbuminemia/gut mucosal atrophy Pancreatic insufficiency Inadequate GIT surface area Rapid GIT transit Radiation enteritis Tube feeding related Rapid formula administration Formula hyperosmolalty Low residue (fiber) content Lactose intolerance Bacterial contamination... 

On the other hand, constipation may occur in some patients receiving tube feedings, especially the elderly. Increased provision of fluid or fiber may be useful in attaining bowel regularity. As with diarrhea, constipation maybe drug-related, in which case discontinuation or replacement of the offending drug may help to alleviate the problem. 

The most common drug-related adverse experiences in patients treated with ertapenem, including those who were switched to therapy with an oral antimicrobial, were diarrhea, infused vein complication, nausea, headache, vaginitis, phlebitis/thrombophlebitis, and vomiting. 

In Study 102, 32 patients were enrolled and treated with doses up to 45.7 mg/ m2 [18]. The MTD was 34.4 mg/m2, with the DLT being neutropenia. Other common, drug-related toxicities included mild to moderate fatigue, anemia, nausea, anorexia, emesis, alopecia, and diarrhea. The best observed antitumor response consisted of stable disease, and this was noted in 10 patients the median duration on study for those patients with stable disease was 99.5 days compared to 37.5 days for those with progressive disease. 

The effects of abacavir have been evaluated in a study in over 13 000 adults who no longer responded to commercially available treatment regimens (2). By month 2 of treatment with abacavir, plasma HIV-1 RNA concentrations fell by at least half a log unit in 31% of patients, and in 5.6% of the patients HIV-1 RNA concentrations fell to under 400 copies/ml. Serious drug-related adverse events were reported by 7.7% of patients. The most common were nausea, skin rash, diarrhea, malaise or fatigue, and fever. About 4.6% of patients had a hypersensitivity reaction that was possibly drug-related. 

In a multicenter, open, randomized comparison of levofloxacin 500 mg/day orally or intravenously and azithromycin 500 mg/day intravenously for up to 2 days plus ceftriaxone 1 g/day intravenously for 2 days in 236 patients, the most common drug-related adverse events in those given azithromycin were diarrhea (4.2%), vein disorders (2.5%), and pruritus (1.7%) (10). 

Oral ciprofloxacin (10 mg/kg bd) was as safe and effective as intramuscular ceftriaxone (50 mg/kg/day) in the treatment of acute invasive diarrhea in 201 children (aged 6 months to 10 years) (64). Possible drug-related adverse events occurred in 8% and were mild and transient. Joints were normal during and after the completion of therapy in all patients. 

In a prospective, uncontrolled, unbhnded, phase III trial in 254 patients with community-acquired pneumonia diagnosed by culture or serologically, moxifloxacin (400 mg/day orally for 10 days) produced a bacteriological response of 91% (9). Drug-related adverse events were reported in 33% of patients nausea (9%), diarrhea (6%), and dizziness (4%) were the most common adverse events. 

In a multicenter, open, uncontrolled trial of protease inhibitors in conjunction with NRTIs for at least 96 weeks in 32 children, the pharmacokinetics of indinavir and nelfinavir showed large interindividual differences (8). In all, 17 children suffered adverse events. The most common adverse events in those taking indinavir were diarrhea (n = 6), vomiting (n = 6), anorexia (n — 5), hematuria ( = 5), abdominal pain (n — 4), and headache (n = 3) most were mild and occurred early in treatment. The rates of drug-related adverse effects were 0.4 per patient-year in those taking indinavir and 0.16 per patient-year in those taking nelfinavir. 

Patients treated for intraabdominal infections should be assessed for the occurrence of drug-related adverse effects, particularly hypersensitivity reactions (/ -lactam antimicrobials), diarrhea (most agents), fungal infections (most agents), and nephrotoxicity (aminoglycosides). 

Etoricoxib was generally well tolerated in clinical trials in patients with osteoarthritis, rheumatoid arthritis, ankylosing spondylitis, and acute gouty arthritis. The most commonly reported drug-related adverse events were generally GI (e.g. dyspepsia, upper abdominal pain, diarrhea, nausea) or CV (e.g. hypertension and peripheral edema). 

Placebo-controlled studies The efficacy and safety of prucalopride 2 or 4 mg/day for 12 weeks has been assessed in a double-blind, placebo-controlled trial in patients with severe chronic constipation [15 ]. The most common drug-related adverse events included headache, abdominal pain, nausea, and diarrhea (which occurred mainly on day 1 of treatment). However, there were no differences in the incidences of serious adverse effects or cardiovascular events compared with placebo. 

In a double-blind, randomized, placebo-controlled trial of prucalopride 2 or 4 mg/day for 12 weeks in 716 patients with chronic constipation, the most common drug-related adverse events were headache, nausea, abdominal pain, and diarrhea [16 "]. The overall incidence of prolongation of the QT interval was low and similar among all treatment groups. Withdrawals as a result of these adverse events accounted for a higher dropout rate in those who took prucalopride 4 mg/day (15%), than in the other treatment groups (6.3% and 6.7% with 2 mg/day and placebo respectively). 

Diarrhea related to superinfedion secondary to antibiotic therapy, adverse drug reaction... 

The most common adverse reactions seen with this drug are related to the gastrointestinal tract and may include nausea, anorexia, and occasionally vomiting and diarrhea The most serious adverse reactions are associated widi die CNS and include seizures and numbness of die extremities. Hypersensitivity reactions also may be seen. Thrombophlebitis may occur widi intravenous (IV) use of die drug. 

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