Gastrointestinal tract symptoms and conditions

I was prescribed a generic for keflex (cephalexin), 500mg three times a day for 10 days for cellulitis(skin infection through an insect bite). My gastrointestinal tract went totally haywire as soon as I started taking the medication, bad stomach upset. The infection subsided in a couple of days but started having stomach cramps and the diarrhea continues for almost a month till I started taking probiotics to replenish all the flora in the gi tract.
It has been almost a month after I stopped taking this medication and now experience phantosmia( phantom smell ), in my case smelling smoke/exhaust fumes at random times throughout the day. I mentioned this symptom to the doc and according to here, it is one of the side effects asked me to hang in there for 5 more months before I can consult an ENT specialist.

Sorry, I can't just walk away.

When you find patents or patent applications for certain purposes, then you know that your ideas are well founded. There are several patents for using an anti-malaria drug for asthma. I would bet that somebody had that idea all the way back to the 1960's. So it is very possibly no coincidence at all that a chloroquinoline or other quinoline ring would be part of montelukast's chemical structure.

Here is one of the patents.

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It is well known that quinoline rings can be toxic to some people even very rapidly. As in this very extreme example.
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PEDIATRICS Vol. 27 No. 1 January 1961, pp. 95-102 This Article

FATAL ACUTE CHLOROQUINE POISONING IN CHILDREN
Howard M. Cann M.D.1 and Henry L. Verhulst M.S.1

1 National Clearinghouse for Poison Control Centers, Accident Prevention Program, Public Health Service, U. S. Department of Health, Education, and Welfare
Four cases of acute chloroquine poisoning in children are presented. In three instances death occurred within 2 hours of ingestion of larger than therapeutic amounts of the drug. The rapid occurrence of death in acute chloroquine poisoning is probably explained by complete and rapid absorption of the drug from the gastrointestinal tract resulting in high blood concentrations which depress vasomotor function and respiration. Cardiac arrest follows and may be caused by the direct myocardial action of chloroquine, to anoxia, or to both. The similarity of the manifestations of acute chloroquine poisoning and those of acute quinine and quinidine poisoning suggests that acute toxicity may be attributed to the quinoline ring portion of these drugs.

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I don't think that we are seeing extreme examples. But we may be seeing less extreme immediate reactions or reactions where the toxicity builds up over time.

Quinoline rings are know to cause neurotoxicity. There are theories about how that happens. One of the theories is about blocking connexins which are gap junction proteins in the brains.

I don't know how montelukast could be breaking up so that it causes toxicity. Or if the problem is the how rapidly the liver enzymes can metabolize it. But there is plenty, plenty, plenty of clinical evidence that there is a quinoline ring culprit somewhere in the picture. Or some by-product of that causing problems.

Somehow it was decided that montelukast did not have the safety issues that the other drugs in the same category have. See this.

"The starting point in the development of montelukast appears to be a quinoline-containing structure, likely identified as a weak random screening lead (Figure 3). The Merck group hypothesized that this molecule was mimicking the olefin backbone of cysLTs, and that the addition of mimics for the acid and peptide regions of LTD4, might improve its potency. As a first step, the dithioacetal linkage first seen in some SmithKline compounds was incorporated; this led to a compound with greatly increased in vitro potency but poor oral bioavailability. When one of the carboxylic acids was replaced by an amide, forming MK-571, the new antagonist had even greater potency and good efficacy following oral administration. The enantiomers were resolved to yield MK-679 (verlukast), a compound with better clinical effects than MK-571, but whose clinical development was stopped for safety reasons. Further structure-activity relationship studies led to the development of montelukast (16), an antagonist that appears free of the safety concerns plaguing earlier members of this series."

If we can find out why the earlier versions were not safe and how they thought fixed it, then maybe we can find out what is going on with the quinoline ring in some people.

I would be very surprised if the FDA will address our concerns. Why does it always seem like they wait for enough people to die like in Vioxx? Wasn't Vioxx responsible for thousands of deaths?

i have just finished my ten day use of sulfameth with no side effects. I know that the antibiotics kill ALL bacteria good and bad so i ingested more yogurt and Vitamin B tablets to help with the bacteria in my gastrointestinal tract. And, some people probably itch because of the bacteria living on the skin.

My very trusted psychiatrist changed my meds from Effexor to Zoloft after I complained of continuing depression and the usual suspects...Crying all the time...Zoloft was to be the "cry stopper". A week went by after the initial introduction and he increased the meds to 175 mg 2xper day. OH MY GOD-- I have never been worse off, my intestines were constantly churning and I was in the bathroom 8-12 per day and was incontinant at nighttime. Truly disgusting and violent diarhea. Not only that I didn't put 2 and 2 together and went to my physical doctor and she had me give a stool sample and you had to do it yourself. How humiliating and vile. I have now been off the Zoloft for over a week and I still am having the symptoms of gas and diarhea but not as bad, but I am wondering when they will go away? Anyone here have any ideas. I was on 175 mg 2x/day for approx 2 months. I'm wondering just what kind of damage that did to my gastrointestinal tract!!!
I still trust my Psych, he ddn't know I was going to have an allergic reaction of sorts. Hopefully I won't ever have to deal with this again. I also am having a light headed ness and that weird Acid-creepy feeling when I quit cold turkey. But after finding out that it was the culprit to the diarhea, I wouldn't take one more pill.

Jacquie in San Diego