Diarrhea opiates

When an opiate is used as an antidiarrheal drug, the nurse records each bowel movement, as well as its appearance, color, and consistency. The nurse should notify the primary health care provider immediately if diarrhea is not relieved or becomes worse if die patient has severe abdominal pain or if blood in die stool is noted. 

Phyto chemicals can be used to either stimulate or inhibit motility of the GIT. For example, caffeine and other phytochemicals stimulate motility (Lis-Balchim etal, 2001 Boekema et al, 1999), whereas motility is slowed by peppermint oil (Beesley et al, 1996), protease inhibitors (Schwartz et al., 1994) and several other phytochemicals (Abdullahi et al, 2001 Odetola and Acojenu, 2000 Rojas et al, 1999 Amos et al, 1998). Many of the traditional herbal medicines used for treatment of diarrhea are based on aqueous extracts that slow small intestine transit and increase residence time for digesta (Lin et al, 2002). The opiates and derivatives are particularly noteworthy (Williams et al., 1997). 

Opiates and various derivatives are commonly used to treat diarrhea, partly because they inhibit electrolyte secretion (Suzuki et al., 2000 Tumberg, 1983). Other phytochemicals counter the secretory responses to cholera toxin (Oi et al., 2002). An example would be the decreased chloride secretion caused by proanthocyanide and the ability to inhibit the secretory diarrhea caused by cholera toxin, but only if administered first (Hor et al., 1995). In the light of the co-transport of water and electrolytes by carriers of glucose... 

All infants developed deviant neurobehavioral symptoms within the first 24 hours of life. Most commonly, the neonates were found to have symptoms of irritability, tremors, and hypertonicity. Bizarre eye movements and staring spells were seen in 25 percent of infants. Poor sucking, lethargy, diarrhea, and facial twitching, symptoms commonly associated with prenatal opiate exposure, were seen infrequently in these PCP-addicted infants. 

Loperamide is an opiate that is poorly absorbed from the G1 tract but still retains the ability to inhibit peristalsis It is useful in diarrheas that are just symptomatic and are not due to infection or organic pathology, such as inflammatory bowel disease. 

Opiates and opioid derivatives delay the transit of intraluminal content or increase gut capacity, prolonging contact and absorption. The limitations of the opiates are addiction potential (a real concern with long-term use) and worsening of diarrhea in selected infectious diarrheas. 

Norepinephrine NE transporter Human cDNA Depression, Alzheimer s disease, epilepsy, anxiety, attention deficit hyperactivity, angina, asthma, cardiac arrhythmia, cardiac hypertrophy, congestive heart failure, myocardial ischemia, hypertension, artherosclerosis, narcolepsy, orthostatic hypotension, prostatic hyperplasia, rhinitis, diabetes, diarrhea, glaucoma, impotence, obesity, opiate withdrawal pain, Raynaud s disease, preterm labor pain Modulation of norepinephrine concentration in the neuronal synaptic clefts, neuroprotection... 

Loperamide is presently used more often as an antidiarrheal drug than as an analgesic, and it is also included in the list of over-the-counter drugs because of its insignificant action on the CNS. It reduces intestinal smooth muscle tone and motility as a result of binding to intestinal opiate receptors. It is used for symptomatic treatment of severe and chronic diarrhea of various origins. The most popular synonym for loperamide is imodium. 

Acute gouty arthritis Begin at the first warning of an acute attack. Usual initial dose is 1 to 1.2 mg follow with 0.5 to 1.2 mg every 1 to 2 hours, until pain is relieved, or nausea, vomiting, or diarrhea occurs. (Opiates may be needed to control diarrhea.) After 1 or more attacks, patients can often judge their requirements accurately enough to stop before the diarrheal dose. ... 

Opiates produce constipation by affecting receptors in the intestines. Opium extracts were used in this capacity to treat diarrhea. Today there are other related compounds on the market which accomplish the peripheral task without affecting the CNS because of their poor absorption from the Gl tract when taken orally. Imodium A-D , an OTC, contains loperamide. It is also available as a generic OTC. The prescription mixture of diphenoxylate and atropine is called Lomotil . 

Opioid derivatives used to treat diarrhea are listed in Table 27-3. Opium tincture (laudanum) and camphorated opium tincture (paregoric) are naturally occurring opiates that are very potent inhibitors of peristalsis. These natural agents are still available for treating diarrhea, but they have essentially been replaced by newer opioids such as diphenoxylate and loperamide. These newer opioids are somewhat less potent but may produce fewer side effects. 

Several powerful and important modem medicines are derived from opium or are synthetic or semi-synthetic narcotics with opiate-like effects. Many of these medicines are primarily used to control pain but are also used to control coughs and diarrhea, and as anesthesia. 

Narcotics (opiates and opioids) are natural, semisynthetic, and synthetic derivatives of the opium poppy. Drugs such as morphine, codeine, heroin, methadone, Darvon, and Percodan fall into this category. They are all depressants, but they are also potent painkillers, and except for heroin (which is illegal) they are prescribed to relieve pain and to control coughing and diarrhea. But because of their pleasurable effects and addictive properties, they can cause problems when taken for nonmedical reasons. Most nonmedical users take these drugs to experience euphoria, to avoid pain, and to relieve withdrawal symptoms. —... 

Further pharmacological effects of deltorphins have been demonstrated under various experimental conditions. D-Ala-deltorphin improves memory consolidation in a passive avoidance apparatus in mice this effect is abolished by naltrindole [75]. D-Ala-deltorphin-II caused hypothermia in cold-adapted animals [76]. In contrast to mu opiate agonists, D-Ala-deltorphin-I, at low doses, stimulates respiratory activity in fetal lambs, and this effect is blocked by simultaneous administration of naltrindole [77], The peptide D-Ala-deltorphin-II inhibits diarrhea induced by castor oil and colonic bead expulsion, but it leaves the rate of transit through the small intestine unchanged [78,79]. By the SC route D-Ala-deltorphin-I inhibits acidified alcohol-induced gastric mucosal lesions [80], but by the ICV route, it fails to affect gastric secretion [81], The peptide is involved also in the control of ingestive behavior. It stimulates the intake of food [82] and of sucrose [83],... 

Pharmacological studies with selective agonists have shown that opioid control of intestinal electrolyte transport is predominantly mediated by delta opioid receptors [58], while the gastrointestinal propulsion is under the control of mu receptors [59,60]. The antidiarrheal effects of NEP inhibitors, such as acetorphan, the prodrug of thiorphan, have been compared to those of an opiate agonist, loperamide, in a model of castor oil-induced diarrhea in rats. When administered peripherally, they produced a delayed onset of diarrhea with no reduction in the gastrointestinal transit [61,62], as is commonly observed with loperamide [63],... 

One of the commonest drugs usL d to treat intestinal cramps and diarrhea is Lomotil, a combination of a synthetic opiate called diphenoxylate and atropine, one ot the constituents of nigiushade plants. Both of these drugs reduce the movement of the intestines by paralyzing the nerves that control them. Diphenoxylate is a close chemical relative of meperidine (Demerol), one of the strong medical narcotics. Like its relative, diphenoxylate can cause depression ot the nervous system that may he intensified by simultaneous use of other depressants. It can also cause euphoria and dependence. Many patients who take Lomotil for intestinal upset experience narcotic effects on mood but have no idea they are using an opiate. 

Enkephalins are pentapeptides that bind to opiate receptors. In the gut, enkephalins promote the absorption of sodium, chloride and water (Dobbins et al 1980). Racecadotril is an oral enkephalinase inhibitor used in France and the Philippines for the treatment of acute diarrhea. It prevents the degradation of endogenous opioids (enkephalins) and thus promotes absorption of water and electrolytes from the intestinal lumen (Matheson Noble 2000). Studies have demonstrated the efficacy of racecadotril in two models of hypersecretory diarrhea infusion of cholera toxin and castor oil induced diarrhea. Moreover, unlike loperamide, racecadotril did not prolong transit time in the small intestine or colon. Further experiments have shown that racecadotril does not promote bacterial overgrowth in the small intestine (Duval-Iflah et al 1999). There are no reports on the use of racecadotril in horses. 

The constipating effect of orally administered opiates can be used for the treatment of diarrhea, as with camphorated tincture of opium (Paregoric or Parepectolin, which is a paragoric plus kaolin as an adsorbent and pec-... 

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