In geriatrics, I see frequent use of acteylcholinesterace inhibitors for dementia. Some examples include: Aricept (donepezil), Exelon (rivastigmine).

One of the hallmark side effects of this class of dementia drugs is GI symptoms and weight loss. Nausea, loose stools, etc. can and do all happen from time to time.

In a case I came across a while back, it was a classic prescribing cascade example. For those of you who’ve never heard this term, it essentially means treating side effects of one medication with another medication, and this was exactly the case. Exelon patch had been initiated for dementia and was subsequently increased after a month or two. A couple weeks after the increase in Exelon, it was evident they were having some GI symptoms as Zofran (ondansetron) was added to treat symptoms of nausea and stomach upset.

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