Gastrointestinal Side Effects of Antiarrhythmic Medications: A Review of Current Literature

Amjad, Waseem; Qureshi, Waqas; Farooq, Ali; Sohail, Umair; Khatoon, Salma; Pervaiz, Sarah; Narra, Pratyusha; Hasan, Syeda M; Ali, Farman; Ullah, Aman; Guttmann, Steven

doi:10.7759/cureus.1646

Cited by 9 publications

(5 citation statements)

References 41 publications

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“…For example, we observed an eQTL signal in both colonic and esophageal tissues for the ATPase Na + /K + Transporting Subunit Alpha 1 ( ATP1A1 ) gene, a drug target for heart failure, that colocalized with a GWA locus for the “K59 other functional intestinal disorders” phenotype in the U.K. Biobank PheWAS analysis. Clinical trials have shown that drugs targeting ATP1A1 , such as digoxin, can result in nausea, vomiting, and diarrhea ( 17 , 18 ), thus supporting our observed side effect results.…”

Section: Resultssupporting

confidence: 88%

Tissue-specific genetic features inform prediction of drug side effects in clinical trials

et al. 2020

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Adverse side effects often account for the failure of drug clinical trials. We evaluated whether a phenome-wide association study (PheWAS) of 1167 phenotypes in >360,000 U.K. Biobank individuals, in combination with gene expression and expression quantitative trait loci (eQTL) in 48 tissues, can inform prediction of drug side effects in clinical trials. We determined that drug target genes with five genetic features—tissue specificity of gene expression, Mendelian associations, phenotype- and tissue-level effects of genome-wide association (GWA) loci driven by eQTL, and genetic constraint—confer a 2.6-fold greater risk of side effects, compared to genes without such features. The presence of eQTL in multiple tissues resulted in more unique phenotypes driven by GWA loci, suggesting that drugs delivered to multiple tissues can induce several side effects. We demonstrate the utility of PheWAS and eQTL data from multiple tissues for informing drug side effect prediction and highlight the need for tissue-specific drug delivery.

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Section: Resultssupporting

confidence: 88%

Tissue-specific genetic features inform prediction of drug side effects in clinical trials

et al. 2020

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“…These include antibiotics, nelfinavir, zidovudine, NSAIDs, quinidine, vitamins, and miscellaneous isolated drugs from various categories. 3 Antibiotics are by far the major contributor of these cases, especially tetracycline and doxycycline, and the other contributors are bisphosphonates, NSAIDs, and iron pills. Both tetracycline and doxycycline had been reported to cause esophageal injuries almost as much as all other drugs combined.…”

Section: Introductionmentioning

confidence: 99%

Clindamycin-Induced Esophageal Injury: Is It an Underdiagnosed Entity?

Bestari

Agustanti

Abdurachman

2019

Clin Med Insights Case Rep

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There are increased reports of pill-induced esophagitis in the past 2 decades, with almost 100 different substances identified as the cause for more than 700 cases, and the overall incidence is estimated to be 0.004% per year. Antibiotics are one of the major contributors for these cases, especially tetracycline and doxycycline; other major contributors are bisphosphonates, nonsteroidal anti-inflammatory drugs, and iron pills. Clindamycin is commonly prescribed by physicians, yet side effect in the form of esophagitis is uncommon and mostly documented in case report. It is possible that these cases are mostly unnoticed due to initial consideration of common and more serious problems. Thus, patients may be assumed to be having a severe episode of acid reflux, and it is not routinely reported or recognized. In this case series, we presented 8 patients with clindamycin-induced esophagitis. The initial presentation of all patients was odynophagia, which appeared within the first day of taking the antibiotic. All patients were subjected to endoscopic examination and ulcer was found in all cases, in the form of localized solitary or multiple ulcers with sharply defined borders. Patients were treated with proton pump inhibitor and sucralfate, and the symptoms subside within 1 week. Patient education regarding the proper way of ingesting drug seems to be the key factor in the prevention of pill-induced esophagitis. The prevention of esophagitis is even more important with antibiotics as adverse effect would decrease the patient compliance in completing the regimen and would ultimately increase antibiotic resistance.

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“…Beta-blockers are commonly used for several medical conditions such as hypertension, arrhythmia, migraine, glaucoma, and anxiety [ 18 ]. Moreover, beta-blockers are also prescribed as the primary prophylactic agent for upper gastrointestinal bleeding in cirrhotic patients from variceal bleeding [ 19 ].…”

Section: Discussionmentioning

confidence: 99%

Factors associated with serious abdominal conditions in geriatric patients visiting the emergency department

Dadeh,

Uppakarnnuntakul

2024

BMC Emerg Med

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Background Abdominal pain occurs in 20% of geriatric patients who visit the emergency department (ED). Geriatric patients usually have more severe conditions and a higher mortality rate. We aimed to determine the factors associated with serious abdominal conditions in geriatric patients who visit the ED with abdominal pain. Methods This retrospective cohort study was conducted from January 1, 2017 to June 30, 2021. The inclusion criteria were patients aged ≥ 65 years and presented at the ED with acute abdominal pain. Significantly associated factors for serious abdominal conditions were examined using univariate and multivariate logistic regression analyses. Results A total of 1221 patients were included in this study. Multivariate logistic regression analysis showed that the significant factors associated with serious abdominal conditions were male (adjusted odds ratio [AOR] 2.29, 95% CI:1.3–4.04; p = 0.004), anorexia (AOR 2.16, 95% CI:1.08–4.32; p = 0.03), NEWS 5–6 (AOR 2.96, 95% CI:1.35–6.49; p = 0.007), SBP 100–125 mmHg (AOR 1.5, 95% CI:0.75–2.99; p ≤ 0.001), guarding (AOR 6.92, 95% CI:3.39–14.12; p ≤ 0.001), WBC ≥ 14,000 cells/mm3 (AOR 2.08, 95% CI:1.06–4.09; p = 0.034), ED length of stay (EDLOS) 4–8 h (AOR 2.17, 95% CI:1.08–4.36; p = 0.03), and EDLOS ≥ 8 h (AOR 3.22, 95% CI:1.15–9; p = 0.025). Conclusions The statistically significant factors associated with serious abdominal conditions in geriatric patients were male, anorexia, NEWS 5–6, SBP 100–125 mmHg, guarding, WBC ≥ 14,000 cells/mm3, EDLOS 4–8 h, and EDLOS ≥ 8 h.

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Gastrointestinal Side Effects of Antiarrhythmic Medications: A Review of Current Literature

Cited by 9 publications

References 41 publications

Tissue-specific genetic features inform prediction of drug side effects in clinical trials

Tissue-specific genetic features inform prediction of drug side effects in clinical trials

Clindamycin-Induced Esophageal Injury: Is It an Underdiagnosed Entity?

Factors associated with serious abdominal conditions in geriatric patients visiting the emergency department

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