Drugs Used for Diarrhea Flashcards
How do opioid agonists work?
They modulate cholinergic and VIP connections in the submucosal and myenteric plexuses, resulting in:
- decreased intestinal contraction
- increased colonic transit time
- fecal water absorption
Acetylcholine mediates
contraction
VIP mediates
relaxation
Where are opioid receptors located?
mu and delta are on gut smooth muscle
What drug class is loperamide (immodium)
opioid agonists
no rx, no addiction, no analgesia
well tolerated
Diphenoxylate (Lomotil) drug class
opioid agonist
Lomotil adverse effects and interactions
high doses have CNS effects and can lead to opioid dependence
usually mixed with atropine (anticholinergic) to prevent overdose
Interactions: Etoh, barbituates, tranquilizers
How does Kaopectate work?
absorbs bacteria, toxins, and fluids
thereby decreasing stool volume and number
Why shouldnt I take Kaopectate within two hours of other medications?
it can bind them
Kaopectate usage
acute diarrhea (#tacobell)
Drug class:
Lactobacillus
Bifidobacterium
Saccharomyces
Probiotics: live micro-organisms which colonize intestinal wall
Why take probiotics?
Prevent diarrhea
use in IBS, C diff, rotavirus
When should I NOT take probiotics?
If I’m neutropenic
How does cholestyramine (Questran) work?
It is a Resin that binds bile acids and excretes them in stool. used in diarrhea
Why take Cholestyramine (Questran)?
diarrhea
pruritus from biliary obstruction
hypercholesterolemia
Side effects of Cholestyramine (Questran)
constipation
steatorrhea
vitamin DAK def
binds other drugs, take 4 hours apart
Octreotide mechanism of action
its a synthetic somatostatin
- so it inhibits some GI hormone secretion
- also slows GI motility and inhibits GB contraction
Octerotide uses
- for secretory diarrhea secondary to neuroendocrine tumor (Carcinoid, VIPoma)
- short bowel syndrome
- varices
Octerotide side effects
long term gallstones
decreases cyclosporine levels
