Your SlideShare is downloading. ×
Anti diarrheals
Upcoming SlideShare
Loading in...5
×

Thanks for flagging this SlideShare!

Oops! An error has occurred.

×
Saving this for later? Get the SlideShare app to save on your phone or tablet. Read anywhere, anytime – even offline.
Text the download link to your phone
Standard text messaging rates apply

Anti diarrheals

403
views

Published on

What is Diarrhea and what are the drugs that can be used for its treatment.

What is Diarrhea and what are the drugs that can be used for its treatment.

Published in: Education

0 Comments
0 Likes
Statistics
Notes
  • Be the first to comment

  • Be the first to like this

No Downloads
Views
Total Views
403
On Slideshare
0
From Embeds
0
Number of Embeds
0
Actions
Shares
0
Downloads
9
Comments
0
Likes
0
Embeds 0
No embeds

Report content
Flagged as inappropriate Flag as inappropriate
Flag as inappropriate

Select your reason for flagging this presentation as inappropriate.

Cancel
No notes for slide

Transcript

  • 1. Anti diarrhealsFawad ALI
  • 2. Objectives To classify commonly usedantidiarrheals To explain the mechanism of actionand common adverse effects of eachgroup To manage a patient with diarrheaaccordingly
  • 3. Diarrhea Is it one liquid stool each day? Is it several soft, semi formed stooleach day? Is it frequent, watery stools throughout the day and night? Water 60-90% (>90%) is calleddiarrhea
  • 4. DiarrheaAbnormalincrease infrequency andliquidity of stool
  • 5. Causes of Diarrhea Bacterial infections Viral infections Food intolerance Parasites Reaction to medicines Intestinal diseases Functional bowel disorders After surgical procedures unknown
  • 6. BacteriaSource: contaminated food or waterCommon bacteria: Campylobacter Salmonella Shigella Escherichia coli
  • 7. VirusesNorwalk virusCytomegalo virusHerpes simplex virusViral hepatitis
  • 8. Food IntoleranceLactose intolerance
  • 9. ParasitesGardia lambliaEntamoeba histolyticaCryptosporidium
  • 10. MedicinesAntibioticsMagnesium containingAntacids
  • 11. Intestinal diseasesInflammatorybowel diseaseCeliac disease
  • 12. Travelers diarrheaMost common causative organisms: E.Coli, E.Histolytica, Gardia Lamblia, CholeraCan be prevented by: ________________________________ ________________________________ ________________________________ ________________________________
  • 13. Cause SymptomsViral (stomachflu)gastroenteritisNausea, vomiting, watery diarrhea, fever, aches.Usually 1-3 days.BacterialinfectionDiarrhea, fever, chills, sometimes blood or mucus inthe stools. Vomiting less common.Foodintolerance/lactoseintoleranceBloating, gas, cramps, loose stools hours after eatingdairy products or other offending foods. No othersigns of illness or infection.EmotionaldistressCramping, loose stools, predictable during times ofstress.
  • 14. TypesAcute (short term)diarrhea (< 4 week) Bacterial Viral parasiticChronic diarrhea (long term)(> 4 week) Irritable bowel syndrome Inflammatory bowel disease Lactose malabsorption Chronic laxative use
  • 15. Diagnosis History Examination Stool culture Electrolytes Fasting tests Sigmoidoscopy Colonoscopy
  • 16. Pathology Rapid transit of stool Osmotic diarrhea Secretory diarrhea Exudative diarrhea
  • 17. 1. Increased luminal osmolality Non absorbable solute in intestine Promotes retention fluid in intestine Stimulates peristalsis Examples: magnesium antacids, lactasedeficiency
  • 18. 2. Increased chloride secretionFluid follows sodium chlorideinto the intestineExamples: bacterial toxins,laxative abuse
  • 19. 3. Increased intestinal motilityDecreased contact time forfluid reabsorptionExample:diabetic neuropathyIrritable bowel syndrome
  • 20. 4. Exudative diarrheaInflammation of intestinal mucosaDefective fluid reabsorptionExample: ulcerative colitis
  • 21. Approach to patients with diarrheaMaintenance of fluid andelectrolyte balanceUse of anti infective agentsUse of anti diarrheal agents
  • 22. Maintenance of fluid and electrolytebalanceGlucoseSodium chloridePotassium chlorideTrisodium citrateORS
  • 23. Anti infective agentsRarely required
  • 24. Anti diarrheal agents Anti motility agents Adsorbents Fluid and electrolyte transport modifiers
  • 25. Anti motility agents Opiates Anti muscarinic agents(Atropine + Diphenoxylate)
  • 26. OpiatesCodeineDiphenoxylateLoperamide
  • 27.  Diphenoxylate (Lomotil) Loperamide (Imodium)Synthetic drugsChemically related to narcotic meperidineDecrease intestinal motilityTravelers diarrhea
  • 28. MOAInhibition of acetylcholinerelease through presynapticopioid receptor in the entericnervous system
  • 29. Therapeutic Indications Severe or prolonged (>2 to 3 days) diarrhea toprevent severe fluid and electrolyte loss Relatively severe diarrhea in young children andelderly adults. In chronic inflammatory diseases of the bowel(Ulcerative Colitis, Crohns disease) In ileostomies or surgical excision of portions ofthe ileum, HIV/AIDS associated diarrhea When specific causes of diarrhea have beendetermined
  • 30. Adverse effectsConstipationAbdominal crampsDrowsinessDizzinessPhysical dependence
  • 31. CONTRA INDICATIONDiarrhea caused bytoxic material,microorganisms,antibiotic associated colitis
  • 32. Anti cholinergicsDecrease cramping, motility and hyper secretioncombination with opiatesExample:Diphenoxylate + AtropineTwo half lives21/2 h for Diphenoxylate3 to 20 h for atropineOnset of action: 45 to 60 minD.O.A: 3-4 hours
  • 33. Adsorbents
  • 34. AdsorbentsKaolinPectinCharcoalMethyl celluloseBismuth salts
  • 35. MOAAdsorb intestinal toxins
  • 36. Agents reducing electrolytesecretionα 2 agonist

×