drugs induce changes in feces , urine and laboratory values

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من الصيدلى قدم م/ ى عثمان مد حسن مصطفى مح شفيات ة صيدلة المست دبلوم2015 - 2016

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Page 1: Drugs induce changes in feces , urine and laboratory values

مصطفى محمد حسنى عثمان/ مقدم من الصيدلى

2016-2015دبلومة صيدلة المستشفيات

Page 2: Drugs induce changes in feces , urine and laboratory values

changes in feces may be in color , size , consistency , odour

Green stools

If stool passes through the intestine too quickly, there might not be enough time for bile to be digested and broken down to provide the normal brownish stool color..

Examples of drugs that induce green color of stool : indomethacin , iron supplements

Page 3: Drugs induce changes in feces , urine and laboratory values

There are a variety of reasons why stool will be yellow, greasy, and foul smelling. It can be due to the intestine's inability to digest and absorb fat because of diseases of the intestinal lining (such as in celiac disease and cystic fibrosis) because the pancreas is unable to manufacture adequate digestive enzymes.

Examples of drugs that induce yellow color of stool : rhubarb , senna and orlistat

Page 4: Drugs induce changes in feces , urine and laboratory values

Black stools are a worrisome symptom because it may be due to a large amount of bleeding into the GI tract. These stools tend to be tarry (sticky), and foul smelling. This can be a medical emergency; black tarry stools should not be ignored.

Examples of drugs that induce black color of stool : aspirin , salicylates , chloramphenicol , clindamycin ,

iron supplements , ibubrofen , levodopa

Page 5: Drugs induce changes in feces , urine and laboratory values

The most common cause of bright red stool is

bleeding from hemorrhoids.

Examples of drugs that induce red color of stool : heparin , phenyl butazone , senna , salicylates , tetracycline , anti coagulants

Page 6: Drugs induce changes in feces , urine and laboratory values

Which is due to drugs that cause constipation like: Ibuprofen, naproxen Zyrtec ,

Claritin , a multivitamin with iron,

diltiazem and verapamil

Page 7: Drugs induce changes in feces , urine and laboratory values

Which is due to drugs that cause diarrhea like: Chemotherapy medicines used to treat cancer , drugs used to treat heartburn and stomach ulcers, such asomeprazole (Prilosec), esomeprazole (Nexium), lansoprazole (Prevacid), rabeprazole (AcipHex), pantoprazole (Protonix), cimetidine (Tagamet), ranitidine (Zantac), and nizatidine (Axid) , medicinesthat suppress the immune system (such as mycophenolate)

Page 8: Drugs induce changes in feces , urine and laboratory values

may be due to side effects of medicines (especially nonsteroidal anti-inflammatory drugs, such as aspirin, ibuprofen, and naproxen)which

make food to be undigested

Page 9: Drugs induce changes in feces , urine and laboratory values

Normal urine color ranges from pale yellow to deep amber yellow

An unusual urine color can be a sign of disease. For instance, deep red to brown urine is an identifying characteristic of porphyria, a rare, inherited disorder of red blood cells

Page 10: Drugs induce changes in feces , urine and laboratory values

DARK BROWN

Chloroquin

Methyldopa

Nitrates

Nitrofurantoin

Metronidazole

Page 11: Drugs induce changes in feces , urine and laboratory values

Senna

Sulphonamides

Nitrofurantoin

Chloroquin

Primaquin

Page 12: Drugs induce changes in feces , urine and laboratory values

Triamterene

Amitriptyline

Methocarbamol

Methyline blue

Page 13: Drugs induce changes in feces , urine and laboratory values

Phenazopyridine

Sulfasalazine

Rifampin

Warfarin

Heparin

Page 14: Drugs induce changes in feces , urine and laboratory values

Heparin

Phenytoin

Senna

Ibubrufen

Phenylbutazone

Doxirubicin

Page 15: Drugs induce changes in feces , urine and laboratory values

Some people may experience instances of Dark urine while taking Metronidazole.The pigment responsible is most likely to be a metabolite of Metronidazole.. But definitely pay a visit to your physician if the dark color of urine persists even after stopping medication and if you experience any instances of decreased vision, burning or numbness or tingling or painful sensations in the hands or feet, changes in speech patterns and yellow eyes or skin. Alcoholic beverages should be avoided while taking Metronidazole and for at least one day afterwards the completion of medication.

Page 16: Drugs induce changes in feces , urine and laboratory values

it is petredinederivative

Pteridine isan aromatic chemical compound composed of fused pyrimidine and pyrazine rings. A pteridine is also a group of heterocyclic compounds containing a wide variety of substitutions on this structure. Pterins and flavins are classes of substituted pteridines that have important biological activity. Pteridine, is a precursor in the synthesis of dihydrofolic acid in many microorganisms. Pteridineand 4-Aminobenzoic acid convert by the enzyme dihydropteroate synthetase into dihydrofolic acid in the presence of glutamate. The enzyme dihydropteroatesynthetase is inhibited by Sulfonamide antibiotics

Page 17: Drugs induce changes in feces , urine and laboratory values

Discolor urine to dark-brown due to liver problems(hepatotoxicity)

DeprivanSedative cause dark colour of urine by prolonged use

Myfortic and Cellcept(immunosupressant) contain phenol group The mechanism of action appears to be caused by phenol's conjugation by the liver and subsequent excretion by the kidneys

Page 18: Drugs induce changes in feces , urine and laboratory values

drugs may affect the results of clinical laboratory tests

by:

a) In vivo effects, and/or

b) In vitro effects

Page 19: Drugs induce changes in feces , urine and laboratory values

Bilirubin

Daylight, 30% per hour!! ((non-drug

Decrease

Barbiturates induce glucuronyl transferase in

newborns

Any drug with liver toxicity or causing cholestasis

Increase

Methyldopa reacts with diazo reagent

Page 20: Drugs induce changes in feces , urine and laboratory values

Diuretics enhance excretion Decrease

Phenytoin (Dilantin) may cause osteomalacia

Antacids (large amounts), e.g., TUMS

Increase

Page 21: Drugs induce changes in feces , urine and laboratory values

Ascorbic acid interferes with glucose oxidase procedures

Decrease

Ascorbic acid interferes with procedures which utilize reduction

(e.g., reduction of cupric ion, ferricyanide, etc.)

Increase

Page 22: Drugs induce changes in feces , urine and laboratory values

Diuretics, cathartics, aspirin, steroids

Decrease

Blood transfusions Increase

Hemolysis (non-drug)

Refrigeration of whole blood (inhibition of Na/K-ATPase pump)

Marijuana (?)

Spironolactone inhibits Na/K-exchange in renal tubules

Page 23: Drugs induce changes in feces , urine and laboratory values

Marijuana (?) Decrease

After meals

Acetoacetic acid, acetone and ascorbic acid are chromogenic in picratereaction; glucose same as above

increase