28 GI disorders (Adverse effects)

Question 1

H2 antagonists

Answer 1

Cimetidine->Gynecomastia in elderly men

Ranitidine->Little gynecomastia

Question 2

PPIs

Answer 2

Minor GI and CNS side effects, skin rash, elevated hepatic enzyme levels, hypomagnesemia, and hypergastrinemia
High doses: Chronic kidney disease, vitamin B12 malabsorption, increased risk of osteoporosis, CA pneumonia, and C. difficile

Question 3

Gastric antacids

Answer 3

Aluminium hydroxide->Constipation (when used alone)
Magnesium hydroxide->Diarrhea (when used alone)
Calcium bicarbonate->Constipation, rebound in acid secretion (in large doses)

Question 4

Cytoprotective drugs

Answer 4

Sucralfate->Constipation, other GI disturbances, and laryngospasm
Misoprostol->Diarrhea, intestinal cramping, uterine contraction and labour

Question 5

Metoclopramide

Answer 5

CNS reactions (Drowsiness, extrapyramidal effects, seizures), hyperprolactinemia, diarrhea, and hematologic toxicity

Question 6

Muscarinic receptor antagonists

Answer 6

Increased dose->Visual disturbances, urinary retention, and constipation

Question 7

Poorly absorbed sugars (Laxatives)

Answer 7

Fluid and electrolyte loss

Question 8

Stimulant (secretory) laxatives

Answer 8

Abdominal pain, electrolyte and fluid loss

Question 9

Opioid drugs

Answer 9

Constipation

Question 10

Tegaserod

Answer 10

Increased risk of thromboembolic diseases

Question 11

Lubiprostone

Answer 11

Nausea and diarrhea

Question 12

Linaclotide

Answer 12

Diarrhea

Question 13

Alosetron

Answer 13

Ischemic colitis

Question 14

5-HT3 antagonists (Setrons)

Answer 14

Headache, constipation, diarrhea, and less commonly hypertension and elevated liver enzymes
Ondansetron-> Anaphylactic reactions
Dolasetron->Prolonged QT (at high doses)