loperamide

Question 1

what is it usually used for and what context

Answer 1

diarrhoea

context of IBS or infective diarrhoea/gastroenteritis

Question 2

MOA

Answer 2

does not enter the cns so has NO analgesic effect
agnosit of the opoid receptor in the GI tract
increases no-propulsive contractions of the gut smooth muscle and reduces propulsive contractions

Question 3

impact on gut smooth muscle and anal spinchter

Answer 3

transient bowel content is slowed and anal sphincter tone is increased

Question 4

what is the benefit of this altered gut smooth muscle activity

Answer 4

reduced transit allows more time for water absorption therefore making harder stools

Question 5

what can be used when analgesia is required?

Answer 5

codeine phosphate

Question 6

side effects

Answer 6

most GI side effects- cramping, flatulence, constipation f too much, risk of toxicity and dependency

Question 7

when should it be avoided? and why?

Answer 7

pts with UC, where inhibited perstalasis may increase megacolon risk

Question 8

who else should it be avoided in? why?

Answer 8

in c.diffile diarrhoea for same reason as above

bloody diarrhoea for HUS risk

Question 9

interactions

Answer 9

none

Question 10

dose

Answer 10

4mg followed by 2mg per each loose stool

max 8mg daily

Question 11

pt info

Answer 11

use to settle diarrhoea not treat underlying cause
stop at 5 days or if any pain or constipation
monitoring with stool frequency and consistency

Question 12

what is a hospital consideration if diarrhoea is acquired here?

Answer 12

do not give until obtained negative c.diff toxin test or positive viral PCR where aetiology is established