1. Drugs for diarrhea & constipation

2. Diarrhea Causes of diarrhea Nonpharmacologic measures Traveler’s diarrhea –Frequent cause: Escherichia coli –Preventive measures

3. Antidiarrheals Purpose of antidiarrheals Types of antidiarrheals –Opiates and opiate-related agents –Diphenoxylate with atropine –Somatostatin analog, octreotide (Sandostatin) for severe diarrhea –Adsorbents; Kaopectate –Antidiarrheal combinations

4. Constipation Causes Nonpharmacologic measures Laxatives –Laxatives vs. cathartics vs. purgatives Types of laxatives –Osmotic (saline) –Stimulant (contact) –Bulk-forming –Emollient (stool softeners)

5. Osmotic (Saline) Laxatives Types and action Side effect: electrolyte imbalances, hypotension, weakness, etc. Stimulants ( contact) laxatives –Types and action –Side effects: abdominal cramps, electrolyte imbalances

6. Bulk-Forming Laxatives Type and action Administration of bulk-forming laxatives Adverse effects: intestinal obstruction without sufficient amount of water Stool softeners Types and action

7. Bulk-Forming Laxatives (cont’d) Contraindications Inflammatory disorders of the GI tract –Appendicitis –Diverticulitis –Ulcerative colitis Spastic colon Bowel obstruction Pregnancy