NBME Answers : tsarcoidosis's page

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submitted by dubchak7(1), visit this page

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They suggest Misoprostol to counteract NSAIDs... Why not PPIs?

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hayayah PPI's don't have many side effects! If the question didn't involve the diarrhea side effect the answer would have been to give her a PPI. +3

tsarcoidosis I guess one takeaway is that PPIs don't directly cause diarrhea, but they do increase the risk for C-diff, which causes diarrhea. +19

usmleuser007 PPI side-effects: + increased risk for C. diff + Increased risk for resp infections + can cause hypomagnesia + decrease absorption of (Ca2+, Mg2+, & iron) + increased risk of osteoporotic hip fractures (d/t low serum calcium) +2

temmy The patient got severe gastric burning and discomfort as an effect of the drug. My logic was since the patient was taking an NSAID it had to be a COX 1 inhibitor that destroys the protective barrier of the GI mucosa due to inhibition of prostaglandin so we needed to treat with a drug that will regenerate prostaglandin and prostaglandin is a vasodilation which might be the reason for the diarrhea. +1