2. Objectives
To classify commonly used
antidiarrheals
To explain the mechanism of action
and common adverse effects of each
group
To manage a patient with diarrhea
accordingly
3. Diarrhea
Is it one liquid stool each day?
Is it several soft, semi formed stool
each day?
Is it frequent, watery stools through
out the day and night?
Water 60-90% (>90%) is called
diarrhea
12. Travelers diarrhea
Most common causative organisms:
E.Coli, E.Histolytica, Gardia Lamblia, Cholera
Can be prevented by:
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13.
14. Cause Symptoms
Viral (stomach
flu)
gastroenteritis
Nausea, vomiting, watery diarrhea, fever, aches.
Usually 1-3 days.
Bacterial
infection
Diarrhea, fever, chills, sometimes blood or mucus in
the stools. Vomiting less common.
Food
intolerance/lac
tose
intolerance
Bloating, gas, cramps, loose stools hours after eating
dairy products or other offending foods. No other
signs of illness or infection.
Emotional
distress
Cramping, loose stools, predictable during times of
stress.
30. Therapeutic Indications
Severe or prolonged (>2 to 3 days) diarrhea to
prevent severe fluid and electrolyte loss
Relatively severe diarrhea in young children and
elderly adults.
In chronic inflammatory diseases of the bowel
(Ulcerative Colitis, Crohns disease)
In ileostomies or surgical excision of portions of
the ileum,
HIV/AIDS associated diarrhea
When specific causes of diarrhea have been
determined
33. Anti cholinergics
Decrease cramping, motility and hyper secretion
combination with opiates
Example:
Diphenoxylate + Atropine
Two half lives
21/2 h for Diphenoxylate
3 to 20 h for atropine
Onset of action: 45 to 60 min
D.O.A: 3-4 hours