Diarrhoea

Lipopolysaccharide (LPS) endotoxins are characteristic Gram-negative outer-cell components which are produced by many cyanobacteria. Although LPS have been characterized and found to be toxic to laboratory animals after isolation from cyanobacteria, their toxicity to rodents is less potent than the endotoxins of enteric pathogens such as Salmonella Typical symptoms of animals suffering from LPS intoxication include vomiting, diarrhoea, weakness and death after hours rather than minutes. 

Captan (7V-tricblorometbylmercapto-cyclobex-4-ene-l,2-dicarboxamide) [133-06-2] M 300.5, m 172-173". Crystd from CCI4. Large quantities internally cause diarrhoea and vomiting. 

Canadine is bitter and in small doses causes drowsiness and depression. In large doses it gives rise to transient excitement succeeded by depression and paralysis of the central nervous system. Its injection is followed by violent peristalsis with diarrhoea. It is said to have no effect on the blood pressure. The pharmacological action of canadine a- and -meihochlorides was examined by Laidlaw, who found both to have the curare-like action common to ammonium bases, the -isomeride being the more active the relative activities of the four optically active forms are given as h da. ip dp = 1 Q 2 28. 

Pharmacology. Lycorine was first examined by Morishima wl found it relatively non-toxic to mammals. Given per os or subcutaneous, to the dog or cat, it causes, in small doses, salivation and in large dos vomiting and diarrhoea. It has no special effect on the blood pressure death seems to be due to a generalised collapse. Post mortem —hyper m and ecchymoses in the stomach, intestine, pulmonary pleura and end... 

Antidiarrhoeal drugs are used for the symptomatic treatment of diarrhoea (the frequent passage of liquid... 

Due to the rapid appearance of resistance, 5FC is only used as a combination partner for the intensive therapy of established severe fungal infections caused by Candida spp., Cryptococcus neoformans and Aspergillus sp. Anorexia, nausea, vomiting, diarrhoea and or abdominal pain occur in 6% of the patients. Of greater concern is the potential for bone marrow depression (seen in 5% of the patients, all with elevated 5FC levels). 

Viruses are small infectious agents composed of a nucleic acid genome (DNA or RNA) encased by structural proteins and in some cases a lipid envelope. They are the causative agents of a number of human infectious diseases, the most important for public health today being acquired immunodeficiency syndrome (AIDS), hepatitis, influenza, measles, and vituses causing diarrhoea (e.g., rotavirus). In addition, certain viruses contribute to the development of cancer. Antiviral drugs inhibit viral replication by specifically targeting viral enzymes or functions and are used to treat specific virus-associated diseases. 

Cardiac glycosides have a small ratio of toxic to therapeutic concentration. Possible adverse effects are nausea, vomiting, abdominal pain, diarrhoea, fatigue, headache, drowsiness, colour vision disturbances, sinus bradycardia, premature ventricular complexes, AV-block, bigeminy, atrial tachycardia with AV-Block, ventricular fibrillation. There are several mechanisms relevant for their toxic action (Table 2). 

In addition, the alkaloid colchicine (from Colchicum autumnale) blocks tubulin polymerization by binding to heterodimeric (3-tubulin between amino acids 239 and 254. Since it inhibits the MT-dependent migration of granulocytes into areas of inflammation and their MT-dependent release of proinflammatory agents, it is used to treat attacks of gout. Its antimitotic effect in the gastrointestinal system induces diarrhoea. Nocodazole competes for the binding site of colchicine and has similar effects on heterodimeric (3-tubulin. 

Oral formulations of metformin are rapidly and completely absorbed. The agent is poorly bound to plasma proteins its duration of action is determined exclusively by renal elimination. Higher concentrations of metformin than in most tissues are found in the intestinal mucosa, giving tise to common side effects (irritation, diarrhoea etc.). 

Cholera toxin-induced diarrhoea 2. Increased AEA levels after administration of cholera toxin to mice, a model of diarrhoea, exert anti-secretory action in the small intestine 2. Inhibitors of cellular reuptake... 

Entamoeba histolytica is an anaerobic rhizopod that occurs in tropical and subtropical areas. It can cause intestinal and extraintestinal manifestations. It is transmitted orally by ingestion of cysts that develop into trophozoites in the large intestine. Amebic trophozoites release several cytolytic factors, e.g. amoe-bapore, which enable the parasite to invade tissue. In intestinal amoebiasis, E. histolyticatrophozoites invade the intestinal mucosa, causing a form of ulcerative colitis with bloody and mucous diarrhoea. Extraintestinal manifestation of amebiasis results in abscess formation, usually in the liver but sometimes in the brain. 

Irritable bowel syndrome (DBS) is an exceedingly common condition in all societies, characterized by abdominal discomfort or pain in association with altered bowel habit or incomplete stool evacuation, bloating and constipation or diarrhoea, easily go undetected and do not show up with common tests such as blood tests or x-rays. The estimated prevalence in the community is about 10%. Irritable bowel syndrome and its variants, collectively called functional gastrointestinal disorders, constitute 40-50% of all the patients seen by gastroenterologists in Western countries. 

The indications for these agents are in principle identical to those of the non-selective NSAIDs although the substances have not yet received approval for the whole spectrum of indications of the conventional NSAIDs. Because they lack COX-1-inhibiting properties, COX-2-selective inhibitors show fewer side effects than conventional NSAIDs. However, they are not free of side effects because COX-2 has physiological functions that are blocked by the COX-2 inhibitors. The most frequently observed side effects are infections of the upper respiratory tract, diarrhoea, dyspepsia, abdominal discomfort and headache. Peripheral oedema is as frequent as with conventional NSAIDs. The frequency of gastrointestinal complications is approximately half that observed with conventional NSAIDs. 

Several nonpeptidic, orally active vasopressin receptor antagonists have been developed. The dual V1A/V2R antagonist conivaptan is used in the treatment of hyponatraemia and could also become useful for diseases such as congestive heart failure, in which increased peripheral resistance and dilutional hyponatremia both are present [4]. Side effects of conivaptan include headache, injection site reactions, vomiting, diarrhoea, constipation and thirst. 

There are some descriptions of water-borne outbreaks, or even small epidemics of acute gastroenteritis (diarrhoea), cholera and hepatitis E associated with catastrophic floods that occurred in developing countries, such as Sudan [34, 35], Nicaragua [36], Mozambique [37] and West Bengal [37]. On the contrary, no changes in the base-line outbreak incidence have been reported in developed countries after major floods [37, 38]. When infrastructures and water management are adequate, outbreaks of faecal-oral water-borne infectious diseases do not follow flood events, even in the case where water flooding has compromised the security of water facilities [37]. 

Huttly SR, Blum D, Kirkwood BR et al (1987) The epidemiology of acute diarrhoea in a rural community in Imo State, Nigeria. Trans R Soc Trop Med Hyg 81 865-870... 

Stuyver LJ, Lostia S, Patterson SE, Clark JL, Watanabe KA, Otto MJ, Pankiewicz KW (2002) Inhibitors of the IMPDH enzyme as potential anti-bovine viral diarrhoea virus agents, Antivir Chem Chemother 13 345-52... 

Escherichia coli is a cause of enteritis in young infants and the young of farm animals, where it can cause diarrhoea and fatal dehydration. It is a common infectant ofthe urinary tract and bladder in humans, and is a cause of pyelitis, pyelonephritis and cystitis. 

In the gut, many pathogens adhere to the gut wall and produce their toxic effect via toxins which pervade the surrounding gut wall or enter the systemic circulation. Vibrio cholerae and some enteropathic E. coli strains localize on the gut wall and produce toxins which increase vascular permeability. The end result is a hypersecretion of isotonic fluids into the gut lumen, acute diarrhoea and consequent dehydration which may be fatal in juveniles and the elderly. In all these instances, binding to epithelial cells is not essential but increases permeation ofthe toxin and prolongs the presence of the pathogen. 

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