Week 2: GI Tract - Nonspecific Antidiarrheals Flashcards
What are the 3 types of antidiarrheals?
Opioid: Loperamide
Opioid: Diphenoxylate Atropine
Bismuth Subsalicylate
Why are opioids use as antidiarrheals? In other words, what is the MOA? (2)
- most effective antidiarrheal agents
- Activate opioid receptors in the GI to slow intestinal motility (more time for absorption of fluid and electrolytes)
If using opioids as an antidiarrheal, what may occur in patients with IBD?
toxic megacolon (inflammation)
What is the brand name of diphenoxylate (+ atropine)/
lomotil
What is an indication for diphenoxylate + atropine?
diarrhea only
Why is atropine added to diphenoxylate?
to discourage abuse (unpleasant side effects at high doses)
What is the route of administration for diphenoxylate + atropine
PO only (so cannot abuse IV)
What are the adverse effects of diphenoxylate + atropine? (5)
- dizziness
- drowsiness
- Light-headedness
- headache
- N+V
What is the brand name of loperamides?
imodium
What is the MOA of loperamide? (2)
- suppresses bowel motility and bowel secretions
- used to reduce volume of discharge from ileostomies
Do large doses of loperamide produce morphine-like effects, since it is an opioid?
No
What is the brand name of bismuth subsalicylate?
- Pepto bismol
What is the MOA of bismuth subsalicylate? (2)
- coats the walls of the GI tract
- Binds to causative bacteria or toxin, which is then eliminated in stool
What are the adverse effects of bismuth subsalicylate? (7)
- Increased bleeding time
- constipation
- dark stools (can be mistaken for melena)
- hearing loss
- TINNITUS
- metallic taste
- blue gums
