Antidiarrheals (Loperamide, Diphenoxylate-Atropine)
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GI Drugs
- Ondansetron
- Metoclopramide
- Antacids
- Proton Pump Inhibitors (PPIs)
- H2 Blockers
- Bismuth Subsalicylate
- Sucralfate
- Misoprostol
- Docusate (Stool Softener)
- Bulk Forming Laxatives (Psyllium, Methylcellulose)
- Osmotic Laxatives (Lactulose, PEG)
- Stimulant Laxatives (Senna, Bisacodyl)
- Antidiarrheals (Loperamide, Diphenoxylate-Atropine)
- Orlistat
- Octreotide
Summary
Antidiarrheals, including the drugs loperamide and diphenoxylate-atropine, are used to reduce frequency and liquidity of stool.
Key Points
- Antidiarrheals
- Key Drugs
- Loperamide (Imodium)
- Synthetic analog of the opioid meperidine
- Diphenoxylate-atropine (Lomotil)
- An opiate combination drug with anticholinergic properties
- Loperamide (Imodium)
- Mechanism
- Slows intestinal motility by binding to the opiate receptor in the wall of the GI tract
- Increased absorption of fluids and electrolytes in the intestinal tract
- Clinical Use
- Treats Diarrhea
- Provide symptomatic relief (decrease in frequency and liquidity of stool)
- Does not treat the underlying cause (e.g. bacterial infection would also need antibiotics)
- Treats Diarrhea
- Side Effects and Adverse Reactions
- Central Nervous System Effects (Diphenoxylate)
- If given in high doses; generally not seen when given in a low dose
- Euphoria, CNS depression, dizziness, fatigue
- The atropine addition in diphenoxylate-atropine discourages abuse because patients will receive anticholinergic side effects in addition to opioid side effects
- Central Nervous System Effects (Diphenoxylate)
- Key Drugs