Drugs for diarrhea & constipation

Diarrhea

• Causes of diarrhea

• Nonpharmacologic measures

• Traveler’s diarrhea– Frequent cause: Escherichia coli– Preventive measures

Antidiarrheals

• Purpose of antidiarrheals

• Types of antidiarrheals– Opiates and opiate-related agents– Diphenoxylate with atropine– Somatostatin analog, octreotide (Sandostatin)

for severe diarrhea– Adsorbents; Kaopectate– Antidiarrheal combinations

Constipation

• Causes• Nonpharmacologic measures• Laxatives

– Laxatives vs. cathartics vs. purgatives

• Types of laxatives– Osmotic (saline)– Stimulant (contact)– Bulk-forming– Emollient (stool softeners)

Osmotic (Saline) Laxatives

• Types and action

• Side effect: electrolyte imbalances, hypotension, weakness, etc.

• Stimulants ( contact) laxatives– Types and action– Side effects: abdominal cramps, electrolyte

imbalances

Bulk-Forming Laxatives

• Type and action

• Administration of bulk-forming laxatives• Adverse effects: intestinal obstruction

without sufficient amount of water• Stool softeners• Types and action

Bulk-Forming Laxatives (cont’d)

• Contraindications• Inflammatory disorders of the GI tract

– Appendicitis– Diverticulitis– Ulcerative colitis

• Spastic colon• Bowel obstruction• Pregnancy