Antidiarrheal Drugs

Normal bowel movement: An average, healthy person has anywhere from three bowel movements a day to three a week, depending on that person's diet. Normally the stool (the material that is passed in a bowel movement) has a texture something like clay Diarrhea Diarrhea is not a disease, but a symptom of some other problem characterized by either more frequent bowel movement and/or the texture of the stool is thin and sometimes watery Diarrhea is not a disease, but a symptom of some other problem characterized by either more frequent bowel movement and/or the texture of the stool is thin and sometimes watery

Causes of diarrhea: - Diet ( eating something that is difficult to digest ) - Genetic Disorder ( lactase deficiency ) - Infection ( bacterial, viral, fungal, parasitic ) - Toxic - Drug-induced - Stress (IBS)

Diarrhea may be classified into: - Acute ( sudden onset ) Food induced ( traveler’s ) - Chronic ( 2 weeks or longer ) IBD, Stress or Irritable bowel syndrome IBD, Stress or Irritable bowel syndrome **Antidiarrheal drugs help control or relieve diarrhea and some of the symptoms that go along with it e.g abdominal pain or cramps

Goals of treatment: Control the loss of fluids Identify and treat cause Provide symptomatic relief ( antidiarrheal drugs ) Refer to physician if: Persists for several days Blood in stool Severe abdominal pain, cramps

Description Antidiarrheal drugs work in several ways: 1. Locally acting agents ( Adsorbents ): Kaolin often combined with Pectin ( Kaopectate ® ) Kaolin often combined with Pectin ( Kaopectate ® ) Most widely used preparation available in powder Most widely used preparation available in powder dosage form This product adsorbs bacterial toxins, binds water This product adsorbs bacterial toxins, binds water and decreases mucus secretion

Bismuth subsalicylate ( Pepto-Bismol ® ; oral tablets ) Also adsorbs bacterial toxins, decreases the secretion of fluid into the intestine and inhibits the activity of bacteria Also adsorbs bacterial toxins, decreases the secretion of fluid into the intestine and inhibits the activity of bacteria 2. Centrally acting agents ( Inhibit defecation reflex ): Codeine Has limited use because it leads to tolerance, Has limited use because it leads to tolerance, addiction and withdrawal manifestations

Diphenoxylate (+ Atropine= Lomotil ® ) Opium-like drug with less addictive properties Opium-like drug with less addictive properties Widely used combined with Atropine (an Widely used combined with Atropine (an Anticholinergic ) Loperamide ( Imodium ® ) Produces rapid and sustained inhibition of the peristaltic reflex slowing the passage of stools through the intestines which will allow more time for water and salts in the stools to be absorbed back into the body

3. Octreotide It is a synthetic somatoststin analog Highly effective in relieving diarrhea of Carcinoid Syndrome Given SC or in an IV infusion Antidiarrheal medications: Can cause constipation ( major side effect ), Low back pain, headache, distension, rash, abdominal pain, dizziness, dry mouth