Mild diarrhoea

Gastrointestinal In a randomised study of 21 patients with type 1 diabetes and microalbuminuria, additional use of spironolactone (25 mg per day) to RAS blocker showed one case of mild diarrhoea and one case of nausea while on spironolactone therapy [37]. 

The clinical presentation of colitis associated with lincomycin or clindamycin therapy may vary from mild diarrhoea to severe persistent disease. Apparently, the diarrhoea and colitis due to the lincomycins do not constitute a uniform clinical entity. 

Fusidic acid resembles the tetracyclines in being almost equally inhibitory to both bacterial and mammalian ribosomes while normally leaving the latter unharmed through inability to penetrate the manunalian cytoplasmic membrane (Franklin and Snow, 1975). However, there is no chemical resemblance, for fusidic acid is a steroid. Although liable to produce mild diarrhoea, fusidic acid is well tolerated orally, even by children. It is usually reserved for pneumonia, or other coccal infection, resistant to the commoner antibiotics. 

Adverse reactions that are not dose dependent are nausea, vomiting and diarrhoea. Lithium has a low therapeutic index. Some adverse reactions such as thirst and mild polyuria may occur at therapeutic plasma concentrations of 0.4-1.0 mEq/1. At concentrations of 1.0-1.6 mEq/1 diarrhea, nausea and incoordination become prominent. At toxic levels ataxia, confusion and stupor occur potentially leading to coma and death. 

Benefits of treatment were also seen on measures of activities of daily living and behavioural disturbances. Although there is less evidence for other than mild to moderate dementia. There is evidence of more adverse events in total in the patients treated with a ChEl than with placebo. Although many types of adverse event were reported, nausea, vomiting, diarrhoea, were significantly more frequent. 

Adverse effects include headache, flushing, dyspepsia, nasal congestion, abnormal vision (mild and transient), diarrhoea, dizziness, angina pectoris, AV block, palpitation, postural hypotension, priapism etc. 

Adverse effects are headache, sinus abnormality, cough, pharyngitis, diarrhoea, rhinitis, urinary tract infection, rash, anxiety/ nervousness, and muscle cramp. However, most side effects have been mild and transient in nature. Rare cases of hypersensitivity reaction, occasionally severe (e.g. anaphylaxis), have been reported. 

In moderate metabolic acidosis which occurs in cases of mild renal insufficiency, infant diarrhoea, diabetic ketosis etc. 

However the reported adverse effects include mild gastrointestinal reactions (nausea, vomiting, abdominal cramps and diarrhoea). Symptoms of pseudomembranous colitis may appear either during or after antibiotic treatment. The other side effects are allergic in nature viz. skin rash, itching, bronchospasm, hypotension, erythema multiforme, Steven-Johnson syndrome. Other side effects viz. haemolytic anaemia, hypoprothrombine-mia, seizures and thrombophlebitis have been rarely reported. 

Codeine, one of the principal alkaloids of opium, has an analgesic efficacy much lower than other opioids, due to an extremely low affinity for opioid receptors. It is approximately one-sixth as potent as morphine. It has a low abuse potential. In contrast to other opioids, with the exception of oxycodone, codeine is relatively more effective when administered orally than parenterally. This is due to methylation at the C3 site on the phenyl ring (Figure 7.3), which may protect it from conjugating enzymes. It is used in the management of mild-to-moderate pain, often in combination with non-opioid analgesics, such as aspirin or paracetamol. It is valuable as an antitussive and for the treatment of diarrhoea. Side effects are uncommon and respiratory depression, even with large doses, is seldom a problem. 

Side effects. Probably as a consequence of its potent action on the GABAergic system, tiagabine has been shown to cause dizziness, asthenia, tremor, depressed mood and emotional lability. Diarrhoea is also a frequent occurrence. Most of these symptoms are of relatively mild intensity. 

The rationale for the need of recovery animals was frequently discussed. For drag substances which require chronic (live time) treatment (e.g. oral anti-diabetics, drags for treatment of hypertension, anti-Parkinson drugs, etc.) the question of recovery is less important than in the case of anti-infectives with, in most cases, short treatment periods where mild symptoms of intolerance, e.g. diarrhoea, are observed. However, inclusion of recovery animals is recommended in general because at the stage of development where first clinical studies are conducted, the whole set of indications is not finally known and line extensions can happen. One example is the use of quinolones and other anti-infectives for the treatment of cystic fibrosis. Another example is drugs used for chemotherapy of malignant diseases where recovery has to be studies anyway. 

Adverse reactions. Heartburn, nausea and vomiting due to gastric irritation are common, and attempts to reduce this with milk or antacids impair absorption of tetracyclines (see below). Loose bowel movements occur, due to alteration of the bowel flora, and this sometimes develops into diarrhoea and opportunistic infection (antibiotic associated or pseudomembranous colitis) may supervene. Disorders of epithelial surfaces, perhaps due partly to vitamin B complex deficiency and partly due to mild opportunistic infection with yeasts and moulds, lead to sore mouth and throat, black hairy tongue, dysphagia and perianal soreness. Vitamin B preparations may prevent or arrest alimentary tract symptoms. 

Its principal uses are for mild and moderate pain and cough (long-term use is accompanied by chronic constipation) and for the short-term symptomatic control of the milder acute diarrhoeas. There are... 

Diarrhoea ranges from a mild and socially inconvenient illness to a major cause of death and... 

Acute watery diarrhoea in adults can usually be controlled by oral rehydration solutions and one of the antimotility drugs, although in mild cases the abdominal bloating produced by the latter may be less acceptable than the loose stools. While diarrhoea usually lasts only 2-3 days, this may stiU be socially inconvenient, and if s5rmptomatic remedies fail, an aminoquinolone, e.g. ciprofloxacin 500 mg b.d. will be effective. The use of antimicrobials for travellers diarrhoea continues to evoke controversy (see below) but most sufferers will appreciate the relief that even one or two tablets can bring. 

Antimicrobials are the commonest drugs that cause diarrhoea, probably due to alteration of bowel flora. It may range from a mild inconvenience to life-threatening antibiotic-associated (pseudomembranous colitis), due to colonisation of the bowel with Clostridium difficile. The condition particularly affects... 

Among the mild adverse effects (mostly dose-dependent) observed with sulphonylureas we find gastrointestinal disturbances such as nausea, vomiting, heartburn, anorexia, constipation, diarrhoea and a metallic taste, and there may be headache, dizziness, weakness, paraesthesia and tinnitus. Skin rashes and pruritus may occur and photosensitivity has been reported. 

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