Opiates
3 types of Anti-diarrheals: Opiates?
- Diphenoxylate with atropine
- Difenoxin with atropine
- Loperamide (Imodium – OTC)
What may occur from overuse of antidiarrheals drugs?
Encourage ____ ____ to help the bowel rest
Constipation
Clear liquid
Bismuth salicylate is contraindicated in patients with what?
Aspirin sensitivity/allergy
Cautious use in ___ who are at high risk for fecal impaction
Elderly
Crofelmer use?
HIV
Anti-diarrheals: Opiates SE's are DRY or WET? WHY?
SE: Mostly related to the anticholinergic properties of atropine! Drowsiness, dizziness, dry mouth, nausea, vomiting, headache, fatigue, GI distress
Anticholinergic SE due to atropine added
SO ENCOURAGE FLUIDS OR SUCK ON HARD CANDY
What laxative thickens stool by absorbing moisture in stool?
Pectin
Bismuth salicylate is contraindicated in Children/adolescents during or after recovery from _______
During or after recovery from chicken pox or flu-like illness
Eluxadoline use?
IBS
Opiates: Effect on bowels?
Slows peristalsis
What laxative is a antisecretory, antimicrobial, anti-inflammatory?
Bismuth salicylate
- No kids that have had chicken pox
- No aspirin allergy
- Increases risk for hypoglycaemia if given in large doses with DM meds
Alosetron use?
Females with IBS
Opiates: Loperamide (Imodium) does what? BBW?
- Protects against diarrhea, reduces fecal volume, and decreases intestinal fluid and electrolyte losses
BBW: Serious cardiac adverse reaction, torsades de pointes
What is the clay-like powder laxative that attracts and holds on to bacteria?
Kaolin
Rifaximin use?
C. diff and encephalthy
3 drugs explained?
What antidiarrheal ant can cause anti-cholingeric side effects and result in dependence?
- Diphenoxylate with atropine (Contains 50% atropine) – related to meperidine
- Difenoxin with atropine (Contains 50% atropine) – related to meperidine
- Loperamide hydrochloride – (available OTC) – structurally related to diphenoxylate, but causes much less CNS depression
* Diphenoxylate-Atropine*
Bismuth salicylate increases the risk for _____ if given in large doses with insulin or oral _____ medications
Increases the risk for hypoglycemia if given in large doses with insulin or oral diabetic medications