Lubiprostone induced ischemic colitis

Table 1 Medications associated with ischemic colitis

Agent	Mechanism
Amphetamines	Vasoconstriction
Alosetron
Catecholamines (epinephrine, norepinephrine)
Cocaine
Cyclosporine
Digitalis
Dopamine
Ergot derivatives
Nonsteriodal anti-inflammatory drugs
Pseudoephedrine
Triptans (Naratriptan, Rizatriptan, Sumatriptan)
Vasopressin and vasopressin analogues
Glycerin enema	Local vasospasm effect
Phosphosoda solution
Angiotensin-converting enzyme inhibitors	Systemic hypotension
Antipsychotic (chlorpromazine)
Beta blockers
Barbiturates
Diuretics
Interleukin-2
Tricyclic antidepressants
Amphetamines	Vasculitis
Gold compounds
Estrogens	Thrombotic lesion induction
Progestational agents
Alosetron	Increased intracolonic pressure
Danazol
Glycerin enema
Carboplatin	Undetermined
Flutamide
Glutaraldehyde
Hyperosmotic saline laxatives
Interferon-alpha
Mycophenolate mofetil
Paclitaxol
Simvastatin
Tegaserod

With permission to reuse from Elsevier[3].

Table 2 Naranjo adverse drug reaction nomogram in our patient

	Yes	No	Our patient
Are there previous conclusive reports on this reaction?	1	0	0
Did the adverse event appear after the suspected drug was administered?	2	-1	2
Did the adverse reaction improve when the drug was discontinued or a specific antagonist was administered?	1	0	1
Did the adverse reaction reappear when the drug was readministered?	2	-1	2
Are there alternative causes (other than the drug) that could have, on their own, caused the reaction?	-1	2	2
Did the reaction appear when a placebo was given?	-1	1	1
Was the drug detected in the blood (or other fluids) in concentration known to be toxic?	1	0	0
Was the reaction more severe when the dose was increased or less severe when dose was decreased?	1	0	0
Did the patient have a similar reaction to the same or similar drugs in any previous exposure?	1	0	1
Was the adverse event confirmed by any objective evidence?	1	0	1
			10

Definite: score ≥ 9; Probable: 5-8; Possible: 1-4; Doubtful: ≤ 0.