Antimotility drugs Flashcards

1
Q

What are examples of antimotility drugs?

A
  • Loperamide
  • Codeine phsophate
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2
Q

What is the mechanism of action of loperamide?

A

Opioid similar to pethidine that does not penetrate CNS - no analgesic effects. It is an agonist of the opioid mu-receptor in the GI tract. This increases non-propulsive contractions of the gut smooth muscle but reduces propulsive contractions. Transit of bowel contents is slowed and anal sphincter tone is increased

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3
Q

What effect does slowed gut transit have on water content?

A

Allows more time for water absorption, which hardens stool

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4
Q

When would you use codeine phsophate over loperamide?

A

If analgesia was also required

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5
Q

What are side effects of antimotility drugs?

A
  • Constipation
  • Abdominal cramping
  • Flatulance
  • Opioid toxicity - codeine toxicity
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6
Q

Why should you not give loperamide in acute ulcerative colitis?

A

Increases risk of toxic megacolon and perforation

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7
Q

Why should loperamide be avoided in c. diff infection?

A

Risk of toxic megacolon and perforation

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8
Q

When should you avoid using loperamide?

A
  • Acute ulcerative colitis
  • C. diff
  • Acute bloody diarrhoea
  • E. coli infection
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9
Q

Why should you avoid using loperamide in someone with E. Coli?

A

Increased risk of HUS

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10
Q

What are indications for using antimotility drugs?

A

Diarrohea - usually in the context of IBS or viral gastroenteritis

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