Antidiarrheal Drugs

1
Antidiarrheal Drugs
2

• 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

3

• 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)

4

• Diarrhea may be classified into
• - Acute ( sudden onset )
• Food induced ( travelers )
• - Chronic ( 2 weeks or longer )
• 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

5

• 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

6

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

7

• Bismuth subsalicylate ( Pepto-Bismol oral
  tablets )
• 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,
  
• addiction and withdrawal manifestations

8

• Diphenoxylate ( Atropine Lomotil )
• Opium-like drug with less addictive properties
• 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

9

• 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