Question

HH is a 68 yo M who has been admitted to the medical ward with community-acquired pneumonia for the past 3 days. His PMH is significant for COPD, HTN, hyperlipidemia, and diabetes. He remains on empiric antibiotics, which include ceftriaxone 1 g IV qday (day 3) and azithromycin 500 mg IV qday (day 3). Since admission, his clinical status has improved, with decreased oxygen requirements. He is not tolerating a diet at this time with complaints of nausea and vomiting.

Is the nausea vomiting from the IV antibiotics? Possible Cdiff infection? What is,if any, the drug interactions and comorbidities? Any other gi concerns?

Answer 1

Yes, there is a chance of getting nausea and vomiting due to iv antibiotics. In gallbladder diseases that are acquired as a side effects the symptoms include nausea, vomiting and abdominal pain.

The c diff can cause colon infection which can interrupt the digestion and makes loss of appetite. May be for that reason the patient may be unable to eat food

In the condition like copd with hypertension with diabetes with hyperlipidemia the general treatment given was- salbutamol, domperidone, telmisartan, asprin, clopidogrel, atorvastatin, ranitidine and to treat nausea- domperidone, (or) ondansetron.

In these drugs the mild interaction occurred between the domperidone and ranitidine. It can result in the QT prolongation. The moderate interaction was glimiperide and rantidine it can cause hypoglycemia. In this condition use proton pump inhibitors instead of H2 receptor blockers.

The daily use of drugs can cause Gi problems and the age can also disturbs the digestion. Take light meals instead of heavy one. Drink plenty of water. And take good rest to resolve the gastrointestinal problems.