Gastrointestinal side effects

The first two selective COX-2 inhibitors to be marketed and subjected to in depth clinical trials were celecoxib and rofecoxib. Both compounds are as effective as standard NSAIDs in rheumatoid arthritis, osteoarthritis and for pain following orthopaedic or dental surgery. Gastrointestinal side effects were far fewer than with comparator diugs and in fact were no... 

Indomethacin treatment is associated with a high incidence (30%) of side effects typical for those seen with other NSAIDs (see above). Gastrointestinal side effects, in particular, are more frequently observed after indomethacin than after administration of other NSAIDs. The market share of indomethacin ( 5%) is therefore low compared to that for other non-steroidal anti-rheumatic agents. 

Ibuprofen is the most thoroughly researched 2-ary lpropionic acid. It is a relatively weak, non-selective inhibitor of COX. In epidemiological studies, ibuprofen compared to all other conventional NSAIDs, has the lowest relative risk of causing severe gastrointestinal side effects. Because of this, ibuprofen is the most frequently used OTC ( over the counter , sale available without prescription) analgesic. Ibuprofen is highly bound to plasma proteins and has a relatively short elimination half-life ( 2 h). It is mainly glucuronidated to inactive metabolites that are eliminated via the kidney. 

The activity of pyrantel (Antimintii) is probably due to its ability to paralyze die helminth. Fbralysis causes die helminth to release its grip on die intestinal wall it is then excreted in die feces, pyrantel is used to treat round-worm and pinworm. Some patients receiving pyrantel may experience gastrointestinal side effects, such as nausea, vomiting, abdominal cramps, or diarrhea... 

Topiramate Topamax Suspension 300 mg/5 mL Tablet 25, 100, 200 mg Doses should be slowly adjusted up and down according to response and adverse effects (e.g., 150-300 mg twice daily and increase by 300-600 mg/day at weekly intervals) 50-200 mg/day in divided doses drug-drug interactions than carbamazepine, but causes more gastrointestinal side effects and hyponatremia Evidence is limited regarding efficacy Not recommended for the... 

Although generally well tolerated, probenecid can cause gastrointestinal side effects such as nausea and other adverse reactions, including fever, rash, and rarely, hepatic toxicity. Patients should be instructed to maintain an adequate fluid intake and urine output to decrease the risk of uric acid stone formation. Some experts advocate alkalinizing the urine to decrease this risk. 

Systemic adverse effects associated with vaginal azoles are less frequent than with oral products. Local discomfort such as burning may occur with the first application. Fifteen percent of patients experience gastrointestinal side effects with orally administered antifungal agents.13 Oral ketoconazole is associated with hepatic toxicity at a rate of 1 in 15,000.14... 

G, Gasbarrini A Effect of Lactobacillus GG supplementation on antibiotic-associated gastrointestinal side effects during Helicobacter pylori eradication therapy A pilot study. Digestion 2001 63 1-7. 

Makins, R. and Ballinger, A., Gastrointestinal side effects of drugs, Expert Opin. Drug Safety, 2, 421 29, 2003. 

Cavaliere, H., Floriano, 1., and Medeiros-Neto, G. (2001). Gastrointestinal side effects of orlistat may be prevented by concomitant prescription of natural fibers (Psyllium mucil-loid). Int.. Obes. 25,1095-1099. 

Be Patient. Probably the simplest way to manage a side effect is just to wait it out. Granted, this is easier said than done, but sometimes, a side effect that occurs upon starting a new medication resolves within a few days. For example, this is typically the case with the gastrointestinal side effects often experienced by patients prescribed serotonin renptake inhibitors. Within a few days, a patient beginning a SSRI will become adjnsted to the increased levels of serotonin and the stomach queasiness resolves. We find that when advising patients of potential side effects, it helps to reassnre them that certain side effects will likely be short-lived. 

Mobic is the proprietary preparation of meloxicam, a non-steroidal antiinflammatory drug, which is also a selective inhibitor of cyclo-oxygenase-2. It is therefore less likely to cause gastrointestinal side-effects than other nonsteroidal anti-inflammatory drugs. However, it is still best to administer meloxicam after food. 

Selective serotonin re-uptake inhibitors (SSRIs) and tricyclic antidepressants are equally effective. Hov/ever, SSRIs tend to have fewer antimuscarinic side-effects and are less cardiotoxic in case of overdosage. SSRIs tend to cause gastrointestinal side-effects. Both SSRIs and tricylic antidepressants exhibit a time lag before the action of the antidepressants becomes effective. 

Q89 Indometacin is an indole acetic acid derivative that has a lov/er frequency of gastrointestinal side-effects compared v/ith naproxen. Indometacin may cause headache and dizziness as side-effects. 

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