عوارض جانبی داروهای گوارشی

عوارض جانبی داروهای گوارشی

اسلاید 1: عوارض جانبی داروهای گوارشیدکتر محمد طاهر بروشکیگروه فارماکولوژیدانشکده پزشکی مشهد1389

اسلاید 2: گروههای داروییH2- بلوکرهاآنتی کولینرژیکهامهار کننده های پمپ پروتونآنتی اسیدهاآنتی کولینرژیکهاملین هاداروهای پروکینتیککلپرمین

اسلاید 3: Histamine H2-Antagonists H2- Blockers

اسلاید 4: مصرف از راه خوراكي،عدم عارضه جانبي مهمبه جز سايمتيدين:ژينكوماستي (دوز بالا)كاهش قواي جنسي در مردان (تغيير در متابوليسماستروژن)، مهار آنزيمهاي سيتوكروم

اسلاید 5: Unlike cimetidine, ranitidine does not seem to affect cytochrome P450 to any great extent, and therefore is considered to have little effect on the metabolism of other drugs

اسلاید 6: Ranitidine Adverse Effects (mainly by parentral forms)Effects on the cardiovascular system:. Bradycardia, AV block and cardiac arrest has been reported . Also a +ve inotropic effect.Effects on the endocrine system: gynaecomastia, loss of libido, and impotence less than cimetidine

اسلاید 7: Effects on the nervous system: confusion, loss of color vision, aggressiveness, lethargy, somnolence, disorientation, depression, hallucinations and severe headache, Effects on the liver: hepatotoxicity ….. Ranitidine

اسلاید 8: Famotidine Adverse EffectsEffects on the cardiovascular system: 40 mg daily by mouth reduced cardiac output and stroke volume. Also bradycardia and AV block has been reported Effects on the endocrine system: transient hyperprolactinaemia and glactorrhoea Effects on the nervous system: convulsions and mental deterioration in elderly patients with renal failure,

اسلاید 9: Nizatidine Unlike cimetidine, nizatidine does not seem to affect cytochrome P450 to any great extent, and therefore is considered to have little effect on the metabolism of other drugs

اسلاید 10: Adverse EffectsEffects on the cardiovascular system: has been reported to reduce heart rate, also tachycardia, bradycardia, orthostatic hypotension and syncope have been reported rarely with rapid intravenous injectionSome patients taking nizatidine may experience excessive sweating and urticaria; anaemia may also occurNizatidine

اسلاید 11: ….. Nizatidine Nizatidine is considered to have little or no anti-androgenic activity although there are isolated reports of gynaecomastia and impotence

اسلاید 12: Proton Pomp Inhibitors (PPIs)Omeprazole Lansoprazole Rabeprazole Pantoprazole

اسلاید 13: Some of the most frequent side effects of omeprazole are; headache, diarrhea, abdominal pain, nausea, dizziness, trouble awakening and sleep deprivationOmeprazoleSide effectsProton pump inhibitors may be associated with a greater risk of hip fractures, and clostridium difficile-associated diarrhea

اسلاید 14: PantoprazoleThis medication may affect the results of certain lab tests(pantoprazole can cause a false positive for THC)

اسلاید 15: Side effects… LansoprazoleInfrequent: dry mouth, insomnia, drowsiness, blurred vision, rash, pruritusRarely and very rarely: taste disturbance, liver dysfunction, peripheral oedema, hypersensitivity reactions Severe: Gastro-intestinal disturbances (such as nausea 1.3%, abdominal pain 2.1%, diarrhea 3.8%)

اسلاید 16: The most common is headache in 2.4% of patients… Rabeprazole Side effectsDiarrhea, vomiting, nausea, abdominal pains,Constipation, meteorism, dry mouth, increased or decreased appetite, asthenia, anxiety, vertigo,Sleeplessness, thrombocytopenia, skin eruptionGranulocytopenia, leukocytopenia, Erythema, myalgia, arthralgia, muscle or bone pain

اسلاید 17: Prokinetic drugs

اسلاید 18: متوكلوپراميد آنتاگونيست دوپامين است: بروز عوارض اكستراپيراميدال افزايش حركات قسمت فوقاني دستگاه گوارش اثر آن با آنتي كولينرژيكها آنتاگونيزه مي شود بعنوان افزايش دهنده ترشح شير

اسلاید 19: Cisaprideجانشين متوكلوپراميد، بدون عوارض مركزيتحریک گیرنده های 5-HT4 و افزایش cAMP عوارض:ایجاد آریتمی جدی و گاها کشنده قلبی شامل؛تاکیکاردی بطنی و فیبریلاسیون بطنی

اسلاید 20: … DomperidoneAdverse Effectsgalactorrhoea or gynaecomastia: plasma prolactin increased Effects on the cardiovascular system: Sudden death , ventricular arrhythmias with parenteral productsExtrapyramidal effects: such as acute dystonic reactions

اسلاید 21: ColperminIndications And Clinical Uses: For the symptomatic relief of abdominal pain, distension, flatulence and gas associated with the irritable bowel syndrome (IBS). Active ingredient: Peppermint oil

اسلاید 22: Adverse Reactions: Reactions may include heartburn and hypersensitivity to peppermint oil or menthol, which is rare and includes erythematous skin rash, headache, bradycardia, muscle tremor and ataxia… ColperminNot to be used in Children under 15 years of age

اسلاید 23: MisoprostolAdverse EffectsThe commonest adverse effect of misoprostol is diarrhoea. Other gastrointestinal effects include abdominal pain, dyspepsia, flatulence, and nausea and vomiting

اسلاید 24: …. Misoprostol Increased uterine contractility and abnormal vaginal bleeding (including menorrhagia and intermenstrual bleeding) have been reported. Other adverse effects include skin rashes, headache, and dizziness. Hypotension is rarely seen at doses recommended for peptic ulcer disease.

اسلاید 25: آنتي كولينرژيكهامصرف اين داروها به دليل ايجاد خشكي دهان و كاهش حركات پريستالتيك روده ها محدود شده هيوسين ان-بوتيل برومايد دي سيكلومين پروپانتيلن كليدينيوم- C بلادونا پي-بي

اسلاید 26: عوارض جانبي آنتي كولينرژيكها مهمترين عوارض كلاسيك آنتي كولينرژيكها عبارتند از: تاري ديد، احتباس ادرار، ميدرياز، خشكي دهان، يبوست و تاكيكاردي علائم مسموميت شديد با آتروپين عبارتست از قرمزي پوست: ناشي از ديلاتاسيون عروق پوستيخشكي دهان : ناشي از مهار ترشح بزاق داغي : ناشي از جلوگيري از تعريق هيپراكتيويتي : ناشي از تحريك كورتكس مغز

اسلاید 27: AntacidsSide effects from antacids vary depending on individual and other medications they may be taking at the time. Those who experience side effects most commonly suffer from changes in bowel functions, such as diarrhea, constipation, or flatulence.

اسلاید 28: …. AntacidsMilk-alkali syndrome, which is serious toxicity and can be fatalAluminum hydroxide: may lead to the formation of insoluble aluminium-phosphate-complexes, with a risk for hypophosphatemia and osteomalaciaAl(OH)3 + 3HCl → AlCl3 + 3H2O

اسلاید 29: …. AntacidsMagnesium hydroxide: has laxative properties. Magnesium may accumulate in patients with renal failure leading to hypermagnesemia, with cardiovascular and neurological complicationsMg(OH)2 + 2HCl → MgCl2 + 2H2O

اسلاید 30: Laxatives (also known as purgatives or aperients)Laxative Abuse:occurs when a person attempts to get rid of unwanted calories, lose weight.laxative abuse is serious and dangerous, often resulting in a variety of health complications and sometimes causing life-threatening risks.

اسلاید 31: Health consequences of laxative abuseUpset of electrolyte and mineral balances. Sodium, potassium, magnesium, and phosphorusSevere dehydration may cause tremors, weakness, blurry vision, fainting, kidney damage, and, in extreme cases, deathInternal organ damage may result, including stretched or “lazy” colon, colon infection, Irritable Bowel Syndrome, and, rarely, liver damage. Chronic laxative abuse may contribute to risk of colon cancer.

اسلاید 32: شاد و سلامت باشید