title: Commonly used gastrointestinal drugs.
abstract: This chapter reviews the spectrum and mechanisms of neurologic adverse effects of commonly used gastrointestinal drugs including antiemetics, promotility drugs, laxatives, antimotility drugs, and drugs for acid-related disorders. The commonly used gastrointestinal drugs as a group are considered safe and are widely used. A range of neurologic complications are reported following use of various gastrointestinal drugs. Acute neurotoxicities, including transient akathisias, oculogyric crisis, delirium, seizures, and strokes, can develop after use of certain gastrointestinal medications, while disabling and pervasive tardive syndromes are described following long-term and often unsupervised use of phenothiazines, metoclopramide, and other drugs. In rare instances, some of the antiemetics can precipitate life-threatening extrapyramidal reactions, neuroleptic malignant syndrome, or serotonin syndrome. In contrast, concerns about the cardiovascular toxicity of drugs such as cisapride and tegaserod have been grave enough to lead to their withdrawal from many world markets. Awareness and recognition of the neurotoxicity of gastrointestinal drugs is essential to help weigh the benefit of their use against possible adverse effects, even if uncommon. Furthermore, as far as possible, drugs such as metoclopramide and others that can lead to tardive dyskinesias should be used for as short time as possible, with close clinical monitoring and patient education.
authors.affiliation: Center for Brain and Nervous System, Kokilaben Dhirubhai Ambani Hospital and Medical Research Institute, Mumbai, India.
authors.forename: Annu
authors.initials: A
authors.lastname: Aggarwal
authors.affiliation: Center for Brain and Nervous System, Kokilaben Dhirubhai Ambani Hospital and Medical Research Institute, Mumbai, India. Electronic address: drmbhatt@gmail.com.
authors.forename: Mohit
authors.initials: M
authors.lastname: Bhatt
mesh_terms: D005765:Gastrointestinal Agents / Q000009:adverse effects* / Q000145:classification; D006801:Humans; D009422:Nervous System Diseases / Q000139:chemically induced*
chemical_list: D005765:Gastrointestinal Agents
keywords: Gastrointestinal drugs; acute dystonia; drug-induced parkinsonism; extrapyramidal; hyperthermic syndromes; levosulpiride; metoclopramide; neurotoxicity; phenothiazines; proton pump inhibitors; selective histamine blockers; setrons; tardive dyskinesias