Antimotility Drugs

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Give eg's of & indications for antimotility drugs. eg's: loperamide, codeine phosphate Indications: • Diarrhoea - usually in the context of IBS or viral gastroenteritis
MOA of antimotility drugs. Loperamide is an opioid that is pharmacologically similar to pethidine. However, unlike pethidine, is does not penetrate the CNS, so has no analgesic effects. It is an agonist of the opioid µ-receptors in the GI tract. This ^non-propulsive contractions of the gut smooth muscle but reduces propulsive (peristaltic) contractions. As a result, transit of bowel contents is slowed & anal sphincter tone is ^. Slower gut transit also allows more time for water absorption, which (in the context of watery diarrhoea) has a desirable effect in hardening the stool. Other opioids (e.g. codeine phosphate) have similar effects but, unless analgesia is also required, there is little reason to prefer them over loperamide.
SE's of antimotility drugs. GI effects - constipation, abdo cramping, flatulence
CI's, cautions, & important interactions of antimotility drugs. CI's: • Acute bloody diarrhoea (dysentery) - may signify bacterial infxn Cautions: Loperamide should be avoided in: • Acute ulcerative colitis • C. difficile colitis • Diarrhoea associated with broad spectrum AB Important interactions: There are no clinically significant interactions.

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