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Anti-diarrhoeal-drugs-Drugs-for-constipation.pptx
- 2. LEARNINGOBJECTIVES Bythe end of this lecture, you will be ableto: • Enumerate anti-diarrhoeal drugs • Enumerate drugs used to treat constipation • Describe the mechanism of action ofthese drugs
- 3. Diarrhea
- 4. DIARRHEA Abnormal passageof stoolsi.e. Increased frequency or fluidity or weight(>200 g/d) Howfrequent? More than 3 episodes of loosestool/day
- 6. ORS
- 7. • Adsorbent drugs • Anti-cholinergic agents • Opioid and their derivatives • Octreotide PHARMACOLOGICAL MANAGEMENT
- 8. ADSORBENTS Attapulgite Bismuth subsalicylate kaolin-pectin mixture Mechanism of Action • Adsorb causative bacteria or toxins • Also bactericidal action • Also decrease secretions by coating GIT wall
- 9. ANTI-CHOLINERGICS Atropine Hyoscyine Dicycloamine Mechanism of Action Muscarinic receptor blocker (antagonist) • Decrease intestinal muscle tone and peristalsis of GI tract. This slows the movement of fecal matter through the GI tract. • Also decreases hyper secretion
- 10. OPIOIDS AND THEIR DERIVATIVES Codeine Loperamide Diphenoxin, Diphenoxylate Mechanism of Action Opioid-receptor agonist Acts on μ receptors in the myenteric plexus of large intestine and inhibits its activity → Decreases smooth muscle tone → Dec intestinal motility → Increases the fecal contact time with wall → Allows time for more water to be absorbed out of fecal matter.
- 11. Octreotide •Somatostatin analogue •Used todecrease secretory diarrhea •Used for treatment and prophylaxis of acute pancreatitis.
- 12. Constipation
- 13. C ONS TIP ATION Difficult orinfrequent evacuation of dry hardened feacesfrom the bowel How infrequent? Lessthan 3 times/week
- 14. • Mild action, elimination of soft but formed stools. Laxative • Stronger action resulting in more pre-formed/liquid evacuation. Purgative LAXATIVES • Drugs that promote evacuation of stool out of bowel. • Based on intensity of action :
- 15. TREATMENT NON-PHARMACOLOGICAL MANAGEMENT High-fiber diet Adequate fluid intake Regular exercise Heeding of nature's call
- 16. • Bulk forming agents • Stimulant (Irritant) laxatives • Stool softeners • Osmotic laxatives PHARMACOLOGICAL MANAGEMENT
- 17. BULK-FORMING AGENTS Psyllium Methylcellulose Polycarbophil Mechanism of action •They are indigestible, hydrophilic colloids that absorb water → Form a bulky gel that distends the colon → stimulate peristalsis due to pressure against gut wall → easy passage of stool •Contraindicated in presence of megacolon.
- 19. •Magnesium hydroxide should not be given in chronic renal failure
- 20. Stimulant Purgatives •Anthraquinones •Senna •Cascara •Castor oil •Diphenylmethanes •Bisacodyl •Sodium picosulfate •Phenolphthalein •Contraindicated in intestinal obstruction •Chronic use of anthraquinones may lead to melanosis coli. •Phenolphthalein is not used now due to risk of potantial carcinogenicity.
- 21. STOOL SOFTENERS Mechanism of action: Mineral oils • Indigestible with minimal absorption. Coat stools →lubricate it→ allow easierpassage Docusate salts (sodium or calcium) • increases penetration of fluids and lipids into feces →soft bulky stools Glycerine Suppositeries
- 22. Newer agents •Lubiprostone •Linaclotide •Stimulate Cl- channel opening in the intestine •Increase liquid secretion in the gut •Decrease transit time •Used for chronic cnstipation
- 23. Thankyou…..