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At least 307 records · Page 17Linked to original sources
PubMed2004

Interference of Uzara glycosides in assays of digitalis glycosides.

OBJECTIVE: Presentation of a case report and pharmacokinetic investigation in healthy volunteers on the potential interference between cardiac glycosides and glycosides of Uzara, a herbal antidiarrheal preparation. METHODS: Pharmacokinetic pilot investigation of apparent digitoxin and digoxin serum concentrations in 4 healthy volunteers after single-dose administration of 30 drops Uzara (approximately 1.5 ml approximately = 22 mg glycosides). RESULTS: Maximal apparent serum concentrations of digitoxin between 198.0 microg/l and 919.8 microg/l (therapeutic range: 10-25 microg/l) occurred at 4-8 hours after administration. The terminal half-life of the glycosides was 8.87 +/- 2.20 hours. For digoxin, maximal apparent serum concentrations ranged between 1.4 microg/l and 6.34 microg/l (therapeutic range: 0.9-2.0 microg/l) at 6 hours post dosing. CONCLUSIONS: Administration of a single dose of an Uzara preparation, an over-the-counter product, results in false high serum concentrations of digitoxin and digoxin. As described in the manufacturers Summary of Product Characteristics, this preparation should not be given to patients with cardiac failure or arrhythmia who require treatment with cardiac glycosides because of the demonstrated pharmacological actions of uzara glycosides.

Adult↗
PubMed1999

Loperamide (ADL 2-1294), an opioid antihyperalgesic agent with peripheral selectivity.

The antihyperalgesic properties of the opiate antidiarrheal agent loperamide (ADL 2-1294) were investigated in a variety of inflammatory pain models in rodents. Loperamide exhibited potent affinity and selectivity for the cloned micro (Ki = 3 nM) compared with the delta (Ki = 48 nM) and kappa (Ki = 1156 nM) human opioid receptors. Loperamide potently stimulated [35S]guanosine-5'-O-(3-thio)triphosphate binding (EC50 = 56 nM), and inhibited forskolin-stimulated cAMP accumulation (IC50 = 25 nM) in Chinese hamster ovary cells transfected with the human mu opioid receptor. The injection of 0.3 mg of loperamide into the intra-articular space of the inflamed rat knee joint resulted in potent antinociception to knee compression that was antagonized by naloxone, whereas injection into the contralateral knee joint or via the i.m. route failed to inhibit compression-induced changes in blood pressure. Loperamide potently inhibited late-phase formalin-induced flinching after intrapaw injection (A50 = 6 microgram) but was ineffective against early-phase flinching or after injection into the paw contralateral to the formalin-treated paw. Local injection of loperamide also produced antinociception against Freund's adjuvant- (ED50 = 21 microgram) or tape stripping- (ED50 = 71 microgram) induced hyperalgesia as demonstrated by increased paw pressure thresholds in the inflamed paw. In all animal models examined, the potency of loperamide after local administration was comparable to or better than that of morphine. Loperamide has potential therapeutic use as a peripherally selective opiate antihyperalgesic agent that lacks many of the side effects generally associated with administration of centrally acting opiates.

Analgesics, Opioid↗
PubMed1976

[Diphenoxinhydrochloride, a new anti-diarrhea agent].

The new antidiarrheal drug difenoxin hydrochloride is a preparation with a broad range of action; it is suitable for symptomatic treatment of acute and chronic diarrhea of varying etiology and may be administered as additional medication in cases of specific intestinal infections accompanied by diarrhea. Difenoxin hydrochloride was tested in two studies involving 220 patients with acute diarrhea and 41 patients with chronic diarrhea respectively. Side effects were extremely rare and stool frequency and consistency returned to normal at a daily dose of about 6 tablets. This dose could be reduced for the chronic cases after initial treatment with the higher dose. Positive results were obtained within a very short time in more than 80% of the acute cases and in more than 70% of the chronic cases.

Acute Disease↗
PubMedDate not supplied

[Kaopectate in the combined treatment of patients with intestinal infections].

The paper presents results of multiple-modality treatment of patients with acute intestinal infections with making use of the drug preparation Kaopectate incorporating activated attapulgite which is a natural mixture of hydrates of magnesium silicate and silicate of alumina. The above drug has been shown to be endowed with a antidiarrheal and detoxifying activities.

Adult↗
PubMed1997

[Comparative studies on pharmacological and toxic actions of raw fructus Psoraleae and its salt-baked and improved salt-baked products].

The pharmacological and toxic actions of raw Fructus Psoraleae and its salt-baked, and improved salt-baked products were comparatively studied. The leucogenic action of the improved salt-baked product was more effective than that of the original salt-baked one. But no significant difference in antidiarrheal or antiandrogenoid effect was found between the two salt-baked products. The toxicity(LD50 and the injury on kidney) of the improved salt-baked product was lower than that of the salt-baked. one. The results indicate that this improved processing method would contribute to increasing the efficacy and decreasing the toxicity of Fructus Psoraleae.

Androgen Antagonists↗
PubMed1979

Drug therapy reviews: pharmacotherapy of diarrhea.

Gastrointestinal physiology, and the pathophysiology, diagnosis, symptoms and treatment of acute and chronic diarrhea are reviewed. Drugs used in the treatment of diarrhea include opiates (morphine, codeine), synthetic anti-diarrheals (diphenoxylate, loperamide), anticholinergics (atropine, propantheline), adsorbents (kaolin, pectin, cholestyramine resin) and Lactobacillus acidophilus. Chronic diarrhea and acute diarrhea caused by microorgansims, drugs and viruses are described. The management of diarrhea can be divided into three categories: (1) supportive therapy (fluid and electrolyte replacement); (2) symptomatic therapy which improves the consistency of the stool and reduces the frequency of bowel movements; and (3) specific therapy aimed at treating the cause (e.g., antibiotics for bacteria-induced diarrhea) or blocking the cellular mechanisms of fluid and electrolyte loss. Most acute diarrheal conditions can be managed successfully by avoiding oral solids and ingesting carbohydrate-electrolyte solutions. Synthetic antidiarrheals may increase the toxicity associated with bacterial diahhrea.

Adsorption↗
PubMed1975

Intramuscular (15S)-15-methyl prostaglandin F2alpha for midtrimester and missed abortions.

The efficacy of intramuscular 15-me-PGF2alpha as an abortifacient was evaluated in 40 women between 14 and 20 weeks of gestation and 6 patients with missed abortions. Pregnancy was successfully terminated in all the cases. The injection-abortion interval was significantly lower in 20 patients (Group II) who had intracervical laminaria insertion prior to treatment with 15-me-PGF2alpha than in 10 women (Group I) without laminaria insertion (t = 7.2; P less than .001). Abortion was also accomplished in 10 women with ruptured membranes and 6 patients with missed abortions. Gastrointestinal side effects were minimal and acceptable when premedication with antiemetics and an antidiarrheal was used. This study demonstrates the availability of the intramuscular route--a simple, safe, reliable means of terminating pregnancy, especially during the early midtrimester period.

Abortifacient Agents↗
PubMed2003

Traditional therapies for irritable bowel syndrome: an evidence-based appraisal.

Irritable bowel syndrome (IBS) is a common chronic disease that adversely effects quality of life and is associated with substantial direct and indirect health care costs. It is defined by a constellation of symptoms in conjunction with an alteration in bowel function and defecation, and its underlying pathophysiological basis remains unknown. Numerous therapies are available, but many relieve only one symptom of the syndrome, and their effectiveness has not been demonstrated with adequate evidence from high-quality studies. This article reviews the criteria for appropriate design of any treatment study as well as those criteria specific to studies of treatment for functional gastrointestinal diseases. Using these criteria, the author evaluates the published investigations of "traditional" IBS therapies (antidepressants, bulking agents/fiber, antispasmodics, antidiarrheals) and "alternative" IBS therapies (Chinese herbal supplements, peppermint oil, behavioral therapies). Based on this evaluation, the author concludes that the available evidence does not support the effectiveness of any of these treatments and, therefore, none of these treatments can be reliably recommended.

Antidepressive Agents↗
PubMed2003

Diagnosis and management of microscopic colitis.

OBJECTIVE: To describe microscopic colitis (MC) and a stepwise approach to its diagnosis and management. QUALITY OF EVIDENCE: MEDLINE was searched from January 1996 to August 2002. Controlled trials were sought, but due to their relative rarity, most articles cited are well designed retrospective studies and reviews. MAIN MESSAGE: Microscopic colitis in both its collagenous and lymphocytic forms is a relatively common and important cause of diarrhea in middle-aged and elderly patients. It usually presents as chronic watery diarrhea. Results of endoscopic and radiologic examinations are normal; specific histologic findings are seen on colonic biopsy. Once the diagnosis is confirmed, we suggest a stepwise approach to therapy. First-line therapies include antidiarrheal agents; second-line include bismuth subsalicylates and budesonide; third-line include cholestyramine and 5-aminosalicylic acid agents. When patients fail to respond to these therapies, oral corticosteroids or immune modulatory therapy should be considered. For severe unresponsive cases, colectomy is the last resort. CONCLUSION: Microscopic colitis is an important cause of chronic diarrhea. Once the diagnosis is confirmed, a stepwise approach to treatment is suggested.

Adrenal Cortex Hormones↗
PubMed2004

The effect of two antidiarrhoeal drugs on the psychosocial adjustment to illness in chronic functional diarrhoea.

BACKGROUND: Chronic functional diarrhea is an embarrassing symptom, causing the impairment of the quality of life. AIM: We looked for the effect of two antidiarrheal drugs, diosmectite and loperamide on the psychosocial adjustment to illness, a predictor for the health-related quality of life, in chronic functional diarrhea. METHODS: Prospective controlled randomized trial including 50 consecutive patients with chronic functional diarrhea. They received either diosmectite 3 g b.i.d (n=25, 11M/14F, age 43+/-12 years) or loperamide 2 mg b.i.d. (n=25, 12M/13F, 47+/-11 years) for 2 weeks. Diarrhea and four other digestive symptoms were evaluated on a 0-16 scale, as well as patient's satisfaction (scale 1-10) and physician's satisfaction (scale 0-4). Psychosocial adjustment to illness was assessed with the PAIS-SR scale. RESULTS: Symptom score for diarrhea was reduced from 10.5+/-5.7 to 2.6+/-1.2 (mean+/-SD), p<0.001 by diosmectite and from 8.5+/-4.2 to 1.2+/-0.6, p<0.0001 by loperamide. Diosmectite had a stronger effect than loperamide on accompanying pain (p<0.05) and bloating (p<0.01), but not on nausea, anorexia and emesis. The overall ratings of the patient's satisfaction (8.7+/-0.9 vs. 8.2+/-1.1, NS) and physician's satisfaction (3.2+/-0.3 vs. 3.1+/-0.4, NS) were similar. Psychological adjustment to illness was not changed for following items: health care orientation and domestic environment. Diosmectite improved more than loperamide the psychological distress (from 12.7+/-3.8 to 7.7+/-2.1 vs. 11.8+/-3.3 to 9.05+/-2.2, p<0.05), vocational environment (from 3.2+/-1.1 to 2.2+/-1.2 vs. 3.3+/-1.2 to 3.4+/-1.5, p<0.05) and sexual relationship scores (from 6.4+/-2.2 to 3.0+/-1.5 vs. 7.2+/-2.2 to 5.5+/-2.1, p<0.05). Both drugs similarly improved the items: family relationship and social environment. CONCLUSIONS: Diosmectite and loperamide are both potent drugs for chronic functional diarrhea. Diosmectite has better effects on associated symptoms and some items of psychosocial adjustment to illness (distress, sexual activity and vocational environment).

Adult↗
PubMed2006

Can a meta-analysis answer the question: is mucosectomy and handsewn or double-stapled anastomosis better in ileal pouch-anal anastomosis?

Although ileal pouch-anal anastomosis (IPAA) is the procedure of choice for polyposis and ulcerative colitis with medically refractory disease or dysplasia, controversy exists concerning whether mucosal preservation with double-stapled (DS) IPAA is superior to mucosectomy and handsewn (HS) IPAA anastomosis for postoperative function. Prospective studies have shown no statistically significant differences. The use of meta-analysis can strengthen statistical power by combining the data from related studies. A meta-analysis was performed to determine whether there was a significant difference in functional and manometric outcome between HS-IPAA and DS-IPAA. Prospective, randomized studies were identified using a literature search. Functional outcome variables included number of normal continence, minor incontinence, nocturnal evacuation, the ability to discriminate flatus from stool, and antidiarrheal medication. Manometric outcomes included postoperative resting and squeeze anal pressures. Four prospective, randomized trials were identified. Of the 184 total patients, the HS-IPAA group included 86 patients (48 men and 38 women) and the DS-IPAA group included 98 patients (49 men and 49 women). There were no significant differences in functional outcome between HS-IPAA and DS-IPAA. In addition, there was no significant difference in sphincter resting and squeeze pressures between the two patient groups. This meta-analysis demonstrates that DS-IPAA offers no advantage in functional or manometric outcome when compared with HS-IPAA.

Adolescent↗
PubMed1990

[Therapeutic perspectives in the irritable bowel syndrome].

Future treatments of functional intestinal disorders (FID) are essentially dependent on the possible pathophysiologic hypotheses. Schematically, symptoms experienced by patients with FID can be attributed to intestinal (small or large intestine) motor disturbances or to visceral sensitivity derangement, which, in turn, may be primary or secondary to an anomalous response to alimentation, liberation of hormones or neuromediators, or to a "stress" situation. New therapeutic agents can be directed against the symptoms experienced by patients (? action on pain or intestinal transit disorders) or against the initial pathophysiologic mechanisms. In the treatment of functional diarrhea, several substances have been proposed recently. Encephalines are peptides with extremely short duration of action which are degraded by two membranous enzymes, encephalinase and carboxypeptidase. Recently, it has been shown that acetorphan, an inhibitor of encephalinase, is efficacious in acute diarrhea. Alpha-2-antagonists are substances which are capable of slowing intestinal transit time and increasing intestinal absorption. Their antidiarrheic action is moderate, and they do not act on abdominal pain. Molecules that do not traverse the neuromeningeal barrier but that act selectively on the digestive tract and are better tolerated are expected. In patients complaining of severe idiopathic constipation substances capable of stimulating colonic motility are useful: substance P or neurotensin analogues might prove interesting. Antagonists of opium receptors such as Naloxone have proved efficacious in the treatment of certain cases of chronic idiopathic intestinal pseudo-obstructions or severe constipation. The development of orally active substances or with hepatic elimination are a prerequisite. Therapy based on well characterized pathophysiologic abnormalities would be welcome.(ABSTRACT TRUNCATED AT 250 WORDS)

Abdominal Pain↗
PubMedDate not supplied

[Medical mangement of Crohn's disease (author's transl)].

Medical management of Crohn's disease is above all symptomatic. According to the severeness of the case, treatment varies and may be simple (regimen, antidiarrheic agents and sulfamid drugs) or more sophisticated (continous parenteral alimentation). Sulfamids and antibiotics have a definite although temporary action. Pathogenic medication includes: 1) steroid therapy who is active, but its effects are not long stand; 2) immunosuppressors who allow for the reduction of steroid therapy dosages; 3) immunostimulants as proposed by Geffroy. Among those presently studied are Calmette-Guérin vaccine, either given orally or by scarification, and two anti-parasitic drugs, metronidazole and levamisole. Short term results are good but they worsen with time. The main problem is to know when to discuss surgery. As need be, resection although mutilating, should be timely indicated.

Adrenal Cortex Hormones↗
PubMed1990

[Collagenous colitis].

The features of collagenous colitis are briefly summarized on the basis of 24 own patients and a review of the literature. Collagenous colitis is a rare diarrheal disease first described in 1976. The hallmark of this syndrome consists in a thickened layer of subepithelial collagen in the entire colon. Clinically patients present with longstanding, watery diarrhea. Laboratory tests, radiology and colonoscopy are all normal. Therefore the diagnosis is only established, if an alert colonoscopist takes biopsies out of an endoscopically normal appearing mucosa. There is no specific treatment, but patients usually respond to symptomatic therapy with antidiarrheal drugs. Microscopic colitis may represent an early stage of collagenous colitis.

Adult↗
PubMed1989

[Concepts of pharmacy employees concerning the management of diarrhea in children].

The purpose of this study was to establish the concepts of the drugstore salesforce on the management of acute diarrhea in children. The study was carried out in Guatemala by means of a direct interview of 427 employees of an equal number of drugstores, that were representative of the total drugstores in the country. The results showed that one third of the employees only have grammar education or less, that they were young adults without training in medicine or drug therapy, and that it frequent that people ask for medication for diarrhea in children. For food during diarrhea, fat, milk, meat and beans were mentioned as bad foods, and starch gruels, vegetables and soups were mentioned as good food. From the total sample 82.4% stated that antibiotics are indicated always or almost always, 69.8% prescribe antidiarrheicals as caolin/pectine alone or in combination with antibiotics or sulfonamides, and 33.0% prescribe antibiotics, being ampicillin, chloramphenicol and cotrimoxazole the more common; 73.5% prescribe oral rehydration, but only 8.7% of drugstores have oral rehydration salts recommended by WHO/UNICEF. Based on these results it is recommended to establish a longitudinal program in order to train this group of people who are in primary care, on the management of acute diarrhea in children.

Adult↗
PubMed1989

Clonidine prolongs human small intestine transit time: use of the lactulose-breath hydrogen test.

Clonidine, an alpha 2-adrenergic agonist, has been shown to be useful in the treatment of some patients with chronic diarrhea. Previous animal and human studies have suggested that clonidine alters both small bowel fluid absorption and total gut motility. We measured the effect of clonidine 0.3 mg on oro-cecal transit time, using the lactulose-breath hydrogen test. Intestinal transit time in six normal healthy male volunteers after administration of clonidine was 148 +/- 20 min, and was 90 +/- 7 min with a placebo (p less than 0.05). The average prolongation in transit time was 69.5%. We conclude that clonidine may markedly alter human small intestine transit time which explains, at least in part, the mechanism for this agent's antidiarrheal effect.

Adult↗
PubMed1979

Naloxone reversal of drug-induced diarrhea in mice.

The potential role of endogenous opiates in the mediation of the diarrheal actions of prostaglandin-F2 alpha (PGF2 alpha), 5-hydroxytryptophan (5-HTP) and methacholine was investigated. The interaction of the antidiarrheal agents morphine, propantheline bromide and cyproheptadine on the course of PGF2 alpha-induced diarrhea in mice was studied, as were the effects of naloxone on PGF2 alpha-, methacholine-, and 5-hydroxytryptophan-induced diarrhea. The three diarrheal agents, administered intraperitoneally, showed dose-dependent and parallel dose-response curves with the following order of decreasing potency: PGF2 alpha, methacholine and 5-HTP. Naloxone significantly inhibited the diarrhea induced by these agents. The diarrheal action of PGF2 alpha was also significantly attenuated with morphine, propantheline and cyproheptadine. These results suggest that PGF2 alpha, methacholine and 5-HTP induce diarrhea via a common pharmacological mechanism(s) which may involve an interaction with endogenous opiate receptors. However, the antagonism of diarrhea with agents having diverse pharmacological actions would suggest that factors unrelated to an interaction with endogenous opiates may also be involved in the production of diarrhea by the diarrheagenic agents studied.

5-Hydroxytryptophan↗