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Antidiarrheals

QuestionAnswer
Kaolin: kaolin and pectin clay like powder that attracts and holds on to bacteria; not systemically absorbed
bismuth subsalicylate: Pepto Bismol and Kaopectate antisecretroy, antimicrobial used in H.pylori; same contraindications as ASA; used to treat simple diarrhea, chronic infantile diarrhea, traveler's diarrhea
opiates: for diarrhea diphenoxylate with atropine[Lomotil], and diphenoxin with atropine[Motofen], loperamide[Immodium]
Lomotil and Immodium should be used cautiously with inflammatory bowel disease and d/c if abdominal distention occurs
Lomotil contraindicated in: narrow angle glaucoma r/t atropine, caution with prostatic hyperplasia and Down syndrome, not recommended for children <12; should not be used in E.coli, salmonella, shigella, or pseudomembranous colitis
none of the drugs has established safety in children less than 2 years old. Tx is oral rehydration therapy
atropine crosses blood brain barrier Immodium does not
Homemade hydrating solutions: pinch of table salt and 1/2 tsp honey to 8 oz fruit juice for older children and adults; flat non-diet colas alternate with 8 oz water with 1/4 tsp of baking soda
electrolytes commonly lost in acute diarrhea sodium, K+, bicarbonate, and chloride
homemade recipes for children: 1/4 tsp of sugar free kool aid may be added to pedialyte solutions to help taste; Jello, water or sports drinks should be avoided b/c they do not contain enough sodium avoid fruit juices/drinks that contain fructose
homemade recipe for infants: 1/2 cup infant rice cereal mixed with 16 oz water and 1/4 tsp salt
evaluation of hydration in infants: at least 3 wet diapers per 24 hours
if diarrhea resolves when milk products or lactose-based formula, withhold products and if... resolution of diarrhea strongly suggests lactose intolerance
meds needed in exacerbation of inflammatory bowel disease: steroids and sulfasalazine; Immodium along with added fiber in diet and anticholinergics[but if not improvement at 16mg/day for 10 days unlikely to help]
only drugs indicated for travelers diarrhea Pepto, Immodium
only drug indicated for inflammatory bowel Immodim
Created by: heatherbrown2020
 

 



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