Antidiarrhea

Diarrhea is defined as frequent liquid stools that can be caused by foods, fecal impaction, bacteria (Escherichia coli, Salmonella), virus (parvovirus, rotavirus), toxins, drug reaction, laxative abuse, malabsorption syndrome caused by lack of digestive enzymes, stress and anxiety, bowel tumor, and inflammatory bowel disease such as ulcerative colitis or Crohn's disease.

Diarrhea can be mild (lasting one bowel movement) or severe (lasting several bowel movements). Intestinal fluids are rich in water, sodium, potassium, and bicarbonate, and diarrhea can cause minor or severe dehydration and electrolyte imbalances. The loss of bicarbonate places the patient at risk for developing metabolic acidosis. Severe diarrhea can be life threatening in young, elderly, and debilitated patients.

Diarrhea is a symptom of an underlying cause. Therefore, you must treat the underlying cause while treating the diarrhea. Diarrhea can be treated with a combination of medications and nonpharmacological measures such as clear liquids and oral solutions—Gatorade, Pedialyte, or Ricolyte—and intravenous electrolyte solutions.

For example, traveler's diarrhea also known as Montezuma's Revenge is an acute condition usually caused by E. coli that last less than 2 days but it can become severe. A patient experiencing traveler's diarrhea may be given fluoro-quinolone antibiotics and loperamide (Immodium) to slow peristalsis and decrease the frequency of the stools. Fluoroquinolone treats the underlying cause of diarrhea and loperamide treats the diarrhea itself.

Anti-diarrhea medications decrease the hypermotility (increased peristalsis) that stimulates frequent bowel movements. Antidiarrheals should not be used for longer than 2 days and should not be used if a fever is present. Anti-diarrhea medication is available in four classifications.

See antidiarrheals listed in the Appendix. Detailed tables show doses, recommendations, expectations, side effects, contraindications, and more; available on the book's Web site (see URL in Appendix).

Opiates

Opiates decrease intestinal motility thereby decreasing persistalsis. Constipation is a common side effect. Examples are tincture of opium, paregoric (camphorated opium tincture), and codeine. Opiates are frequently combined with other antidiar-rheal agents and can cause central nervous system (CNS) depression when taken with alcohol, sedatives, or tranquillizers. Duration of action is about 2 hours.

Opiate-Related Agents

Opiate-related agents are drugs that are synthetic compounds similar to opiates. These drugs include diphenoxylate (Lomotil) (50% atropine to discourage abuse; amount of atropine is subtherapeutic) and loperamide. Both are synthetic drugs that are chemically related to meperidine (Demerol). Loperamide causes less CNS depression than diphenoxylate and can be purchased over-the-counter. It protects against diarrhea longer than a similar dose of Lomotil, reduces fecal volume, and decreases intestinal fluid and electrolyte losses. These drugs can cause nausea, vomiting, drowsiness, and abdominal distention. Tachycardia, paralytic ileus, urinary retention, decreased secretions, and physical dependence can occur with prolonged use.

Absorbents

Adsorbents coat the wall of the GI tract and adsorb bacteria or toxins that are causing the diarrhea. Adsorbents include kaolin and pectin, which are combined in the over-the-counter drug Kaopectate, and other antidiarrheals. Pepto-Bismol is considered an adsorbent because it adsorbs bacterial toxins. Bismuth salts can also be used for gastric discomfort. Colestipol and cholestyramine (Questran) are prescription drugs that have been used to treat diarrhea.

Anti-Diarrhea Combinations

Anti-diarrhea combinations are miscellaneous antidiarrheals that include colistin sulfate, furazolidone, loperamide, lactobacillus, and octreotide acetate. You may know these brand names drugs to alleviate diarrhea: Lomotil (diphenoxylate HCl with atropine sulfate) and parepectolin (paregoric, kaolin, pectin, alcohol). Most contain a synthetic narcotic ingredient.

Constipation Prescription

Constipation Prescription

Did you ever think feeling angry and irritable could be a symptom of constipation? A horrible fullness and pressing sharp pains against the bladders can’t help but affect your mood. Sometimes you just want everyone to leave you alone and sleep to escape the pain. It is virtually impossible to be constipated and keep a sunny disposition. Follow the steps in this guide to alleviate constipation and lead a happier healthy life.

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