CHAPTER 50 Antidiarrheals and Laxatives.ppt

CHAPTER 50Antidiarrheals and Laxatives Diarrhea Acute diarrhea Sudden onset in a previously healthy person Lasts from 3 days to 2 weeks Self-limiting Resolves without sequelae Diarrhea (contd) Chronic diarrhea Lasts for more than 3 weeks Associated with recurring passage of diarrheal stools, fever, loss of appetite, nausea, vomiting, weight loss, and chronic weakness Causes of Diarrhea Acute Diarrhea Bacterial Viral Drug induced Nutritional Protozoal Chronic Diarrhea Tumors Diabetes Addison’s disease Hyperthyroidism Irritable bowel syndrome Antidiarrheals: Mechanism of Action Adsorbents Coat the walls of the GI tract Bind to the causative bacteria or toxin, which is then eliminated through the stool Examples: bismuth subsalicylate (Pepto-Bismol), kaolin-pectin, activated charcoal, attapulgite (Kaopectate) Antidiarrheals: Mechanism of Action (contd) Anticholinergics Decrease intestinal muscle tone and peristalsis of GI tract Result: slowing the movement of fecal matter through the GI tract Examples: belladonna alkaloids (Donnatal), atropine, hyoscyamine Antidiarrheals: Mechanism of Action (contd) Intestinal flora modifiers Bacterial cultures of Lactobacillus organisms work by: Supplying missing bacteria to the GI tract Suppressing the growth of diarrhea-causing bacteria Example: L. acidophilus (Lactinex) Antidiarrheals: Mechanism of Action (contd) Opiates Decrease bowel motility and relieve rectal spasms Decrease transit time through the bowel, allowing more time for water and electrolytes to be absorbed Examples: paregoric, opium tincture, codeine, loperamide, diphenoxylate Antidiarrheal Agents: Side Effects Adsorbents Increased bleeding time Constipation, dark stools Confusion, twitching Hearing loss, tinnitus, metallic taste, blue gums Antidiarrheal Agents: Side Effects (contd) Anticholinergics Urinary retention, hesitancy, impotence Headache, dizziness, confusion, anxiety, drowsiness Dry skin, rash, flushing Blurred vision, photophobia, increased