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This chapter describes the adverse effects of gastrointestinal drugs. The adverse effects of cisapride include abdominal cramps, diarrhea, headache, dystonic reactions, convulsions, and hypersensitivity. Cisapride cardiotoxicity in association with erythromycin is described in the chapter. Cisapride should be used with caution in patients with severe cardiac disease or other risk factors for developing dysrhythmias, particularly hypokalemia and hypomagnesemia. It should not be given to patients with intestinal obstruction, perforation, or hemorrhage. In adults, metoclopramide has been reported to cause gynecomastia and galactorrhea due to hyperprolactinemia secondary to its dopamine antagonist action. Adverse effects attributable to antiemetic therapy include facial rash, constipation, headache, and weakness. The increased risk of acute liver injury with cimetidine is seen mainly in the first two months of use. In a study discussed in the chapter, gynecomastia and a lobular carcinoma of the breast were reported in a patient with chronic gastric ulcer. The hematological adverse effects of ranitidine include leukopenia, thrombocytopenia, aplastic anemia, hemolytic anemia, and pancytopenia. |
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