GASTROINTESTINAL TRACT
Diarrhea 8C
Warnings/Precautions: Severe ulcerative colitis.
Impaired gag reflex. Semi- or unconsciousness. Risk
of aspiration or regurgitation. Pregnancy (Cat.C).
Interactions: Drugs administered within 1 hr of
start of Golytely may not be absorbed.
Adverse reactions: Nausea, abdominal fullness
and bloating, cramps, vomiting, anal irritation.
How supplied: Disposable jug (4L)– 1
Packets (to make 4L)– 1
OTC PEG 3350
MIRALAX Merck
Osmotic. Polyethylene glycol (PEG) 3350; pwd for
solution.
Indications: Occasional constipation.
Adults: ;17yrs: Dissolve 17g in 4–8oz liquid and
drink once daily for up to 7 days. May need 1–3 days
for results.
Children: ;17yrs: not recommended.
Contraindications: Bowel obstruction (known or
suspected).
Warnings/Precautions: Renal impairment: not
recommended. Nausea, vomiting, abdominal pain
or IBS: exclude bowel obstruction. Avoid prolonged,
frequent, or excessive use. Pregnancy. Nursing mothers.
Adverse reactions: Loose, watery, frequent stools.
How supplied: Powder–119g, 238g, 510g
(w. measuring cap); Single-dose packets (17g)– 10
CV DIPHENOXYLATE ; ATROPINE
LOMOTIL Pfizer
Opioid ; anticholinergic. Diphenoxylate HCl 2.5mg,
atropine sulfate 0.025mg; tabs.
CV Also: Diphenoxylate ; Atropine
LOMOTIL LIQUID
Diphenoxylate HCl 2.5mg, atropine sulfate 0.025mg;
per 5mL liq; alcohol 15%.
Indications: Adjunct to fluid and electrolyte
replacement in diarrhea.
Adults: 2 tabs or 10mL 4 times daily until diarrhea
is controlled. Maintenance: 2 tabs or 10mL daily.
Children: ;
2 yrs: not recommended. 2–12 yrs:
initially 0.3–0.4mg/kg in 4 divided doses until diarrhea
is controlled. Maintenance: 25% initial dose; max 48hrs.
Contraindications: Pseudomembranous
enterocolitis. Obstructive jaundice. Diarrhea caused
by organisms that penetrate intestinal mucosa. Age
;
2 yrs.
Warnings/Precautions: Dehydration. Acute
ulcerative colitis; discontinue if toxic megacolon occurs.
Hepatic or renal disease. Abnormal liver function tests.
Drug abusers. Pregnancy (Cat.C). Nursing mothers.
Interactions: MAOIs may cause hypertensive crisis.
Antimuscarinics may cause paralytic ileus. Potentiates
sedation with alcohol, CNS depressants. May delay
elimination of other drugs metabolized by CYP450.
Adverse reactions: Nausea, vomiting, abdominal
discomfort, paralytic ileus, toxic megacolon, dizziness,
drowsiness, headache, euphoria, tachycardia,
numbness of extremities, pruritus, urticaria,
angioneurotic edema, anticholinergic effects;
respiratory depression (overdosage), atropinism.
How supplied: Tabs– 100, 500, 1000, 2500;
Liq–2oz (w. dropper)
;FIDAXOMICIN
DIFICID Optimer
Macrolide antibiotic. Fidaxomicin 200mg; tabs.
Indications: For the treatment of Clostridium
difficile-associated diarrhea.
Adults: ;18yrs: 200mg twice daily for 10 days.
Children: ;18yrs: not recommended.
Warnings/Precautions: Not for treating systemic
infections (minimal systemic absorption). Pregnancy
(Cat. B). Nursing mothers.
Adverse reactions: Nausea, vomiting, abdominal
pain, GI hemorrhage, anemia, neutropenia.
How supplied: Tabs– 20, 60, 100 ( 10;
10 blister
cards)
;LOPERAMIDE
IMODIUM McNeil Cons & Specialty
Opioid. Loperamide HCl 2mg; caps.
OTC Also: Loperamide
IMODIUM A-D CAPLETS
Loperamide 2mg.
OTC Also: Loperamide
IMODIUM A-D LIQUID
Loperamide HCl 1mg/5mL; cherry-mint flavor;
contains alcohol 0.5%.
Indications: Diarrhea.
Adults: Acute: Initially 4mg, then 2mg after each
loose stool; max 16mg/day. Stop after 48 hours
if ineffective. Chronic: initially 4mg; maintenance
4–8mg/day. Reevaluate if no improvement after 10
days at 16mg/day.
Children: ;
2 yrs: not recommended. 24–47 lbs
( 2–5 yrs): 1mg up to 3 times daily for 2 days (use
liq). 48–59 lbs ( 6–8 yrs): initially 2mg, then 1mg after
each loose stool; max 4mg/day for 2 days. 60–95 lbs
( 9–11 yrs): initially 2mg, then 1mg after each loose
stool; max 6mg/day for 2 days.
OTC Also: Loperamide
IMODIUM ADVANCED
Opioid ; antiflatulent.
Loperamide HCl 2mg, simethicone 125mg; chew
tabs; vanilla-mint flavor.
Indications: Diarrhea with gas.
Adults: Initially 2 tabs, then 1 tab after each loose
stool; max 4 tabs/day for 2 days.
Children: 2–6yrs: Use AD liq. ;
6 yrs: initially 1 tab,
then ½ tab after each loose stool. 48–59lbs (6–8yrs):
max 2 tabs/day for 2 days. 60–95lbs (9–11yrs): max
3 tabs/day for 2 days.
Contraindications: If constipation must be
avoided. Acute dysentery.
Warnings/Precautions: Acute ulcerative colitis
and antibiotic induced pseudomembranous colitis;
