Our library of drug research abstracts drawn from the medical literature is updated on a regular schedule, and you can be assured that new lomotil research articles will be listed here shortly after becoming available to us.
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Medical research on lomotil
[Treating travelers' diarrhea. When should medication be given?]
Internist (Berl). 2007 Dec; 48(12): 1358-64
Birkenfeld G
Along with the dizzying rise in the world's population and economic globalization, travel activity has also increased. Travelers' diarrhea, caused by changed sanitary conditions, has a very different pathogenic spectrum and clinical course from those of our native forms of infectious enterocolitis. Awareness of the warning signs of complications in the clinical course and of the differential diagnoses is therefore a prerequisite for rational therapy. This covers oral rehydration, motility inhibitors, adsorbents, antisecretory agents, probiotics, and last but not least the use of antibiotics, which make an essential contribution if correctly used. There are interesting developments in the form of nonabsorbable antibiotics and new antisecretory agents, which inhibit protein synthesis and enzymes and are increasingly used as antidiarrheal agents with few side effects. In the combination of various therapeutic options in travelers' diarrhea there is still much scope for research. The priority is the correct implementation of the options available today, in order to avoid, as far as possible, therapeutic setbacks and the development of resistance.
Curr Gastroenterol Rep. 2007 Oct; 9(5): 365-72
Abraham B, Sellin JH
Many drugs have been known to cause diarrhea, although their mechanism of action has not been well described. The gastrointestinal tract may become dysregulated when exposed to a drug that could disrupt mechanisms controlling mucosal permeability, transport, motility, and gut metabolism. This review examines the mechanism by which drugs induce diarrhea within the broad classification of watery, inflammatory, and fatty characteristics of the stool. Treatment may vary depending on this classification and usually includes withdrawal of the offending drug. However, in some cases, diarrhea may resolve with continued use or through nonspecific agents, such as Lomotil (Pfizer, New York, NY) or loperamide.
Are one or two dangerous? Diphenoxylate-atropine exposure in toddlers.
J Emerg Med. 2008 Jan; 34(1): 71-5
Thomas TJ, Pauze D, Love JN
Lomotil (Pfizer Inc., New York, NY) (diphenoxylate-atropine) is said to be potentially toxic to toddlers with exposure to as little as one to two tablets. A review of the data on diphenoxylate-atropine poisonings from the American Association of Poison Control Centers annual reports, review articles, and case series disputes this view. Fatalities associated with diphenoxylate-atropine have been reported in toddlers after repetitive or incorrect dosages. Fortunately, trends in pediatric diphenoxylate-atropine ingestions are decreasing. We review the management, trends, and current concepts regarding pediatric diphenoxylate-atropine ingestions.
Lomotil dependence: a note of caution.
Natl Med J India. 2005 Nov-Dec; 18(6): 330-1
Rao R, Agrawal A, Pal HR, Mohan I
Acute anticholinergic poisoning in children.
Hong Kong Med J. 2005 Dec; 11(6): 520-3
Lee AC, So KT
We report two cases of unintentional poisoning with anticholinergic agents. The first patient, a 7-year-old girl, was prescribed four different medications by a general practitioner for treatment of abdominal colic and diarrhoea. All drugs had anticholinergic properties. The second patient, a 16-month-old boy, ingested his mother's cyproheptadine tablets. Both children presented with central and peripheral symptoms and signs compatible with acute anticholinergic syndrome. They recovered spontaneously following intravenous fluid replacement and close observation. Gastric lavage was also performed on the boy. Poisoning with cholinergic antagonists in children is a potentially serious hazard in Hong Kong. It may be avoided by careful prescribing on the part of general practitioners and safe storage of all medicinal products in the home environment.
Gastrointestinal manifestations of Fabry disease: clinical response to enzyme replacement therapy.
Mol Genet Metab. 2005 Aug; 85(4): 255-9
Banikazemi M, Ullman T, Desnick RJ
Gastrointestinal symptoms are often an early and prominent manifestation of Fabry disease, an X-linked inborn error of metabolism caused by the deficient activity of the lysosomal enzyme, alpha-galactosidase A. This enzyme deficiency results in the progressive accumulation of globotriaosylceramide and other glycosphingolipids in tissue lysosomes throughout the body. In classically affected patients, glycosphingolipid accumulation in the vascular endothelium eventually culminates in life-threatening renal, cardiac, and cerebrovascular disease. In addition, over 50% of patients experience post-prandial abdominal pain and diarrhea that interferes with the ability to work and quality of life. Here, we describe four males aged 17-40 years with classic Fabry disease and severe gastrointestinal symptoms who participated in clinical trials of enzyme replacement therapy with agalsidase beta (Fabrazyme, 1 mg/kg every 2 weeks). Before therapy, the three adult patients experienced post-prandial abdominal pain, bloating, and severe diarrhea with 7-10 bowel movements per day every day and the 17-year-old had weekly episodes of diarrhea with six bowel movements per day. Other symptoms included vomiting, food intolerance, and poor weight gain. All patients took medications for these symptoms (diphenoxylate-atropine [Lomotil], ranitidine hydrochloride [Zantac], or sulfasalazine). After 6-7 months of agalsidase beta therapy, all patients reported "no or only occasional" abdominal pain or diarrhea, had discontinued their gastrointestinal medications, and had gained 3-8 kg. These marked improvements in gastrointestinal symptoms have persisted for over 3 years of treatment. In such patients, enzyme replacement at 1 mg/kg effects an early and significant clinical improvement in the gastrointestinal manifestations of Fabry disease.
Deadly pediatric poisons: nine common agents that kill at low doses.
Emerg Med Clin North Am. 2004 Nov; 22(4): 1019-50
Michael JB, Sztajnkrycer MD
More than 97% of pediatric exposures reported to the AAPCC in 2001 had either no effect or mild clinical effects. Despite the large number of exposures, only 26 of the 1074 reported fatalities occurred in children younger than age 6. These findings reflect the fact that, in contrast to adolescent or adult ingestions, pediatric ingestions are unintentional events secondary to development of exploration behaviors and the tendency to place objects in the mouth. Ingested substances typically are nontoxic or ingested in such small quantities that toxicity would not be expected.As a result, it commonly is believed that ingestion of one or two tablets by a toddler is a benign act and not expected to produce any consequential toxicity. Select agents have the potential to produce profound toxicity and death, however, despite the ingestion of only one or two tablets or sips. Although proven antidotes are a valuable resource, their value is diminished if risk after ingestion is not adequately appreciated and assessed. Future research into low-dose, high-risk exposures should be directed toward further clarification of risk, improvements in overall management strategies,and, perhaps most importantly, prevention of toxic exposure through parental education and appropriate safety legislation.
Indian J Exp Biol. 2003 Apr; 41(4): 363-6
Das S, Prakash R, Devaraj SN
Methanolic extract of H. indicus root (MHI) was screened for its antimicrobial activity against S. typhimurium, E. coli and S. flexneri, in vitro and in experimentally induced diarrhoea in albino rats, in vivo. MHI had an anti enterobacteriae effect as evident from agar well diffusion method and decrease in CFU/ml in MHI treated LB broth culture. MHI inhibited the castor oil induced diarrhoea in rats as judged by a decrease in the amount of wet faeces in MHI-pretreated rats at a dose of 500-1500 mg/kg. The results indicated that MHI was more active than standard antidiarrhoeal drug, lomotil. Phytochemical tests revealed the main constituents as tannins, steroids, triterpenoids and carbohydrates. Present findings suggested that MHI might elicit an antidiarrhoeal effect by inhibition of intestinal motility and by its bacteriocidal activity.
J Emerg Nurs. 2003 Jun; 29(3): 290-3
Muller AA
Behind the counter: pharmacies and dispensing patterns of pharmacy attendants in Karachi.
J Pak Med Assoc. 2001 Apr; 51(4): 149-53
Rabbani F, Cheema FH, Talati N, Siddiqui S, Syed S, Bashir S, Zuberi LZ, Shamim A, Mumtaz Q
BACKGROUND: There is little literature available on dispensing patterns and unsupervised sale of medicines from pharmacies in developing countries. OBJECTIVE: This study obtained background information on pharmacies, assessed the level of training, knowledge and dispensing patterns of pharmacy attendants in Karachi. METHODOLOGY: This is a descriptive cross sectional study with convenient sampling. A structured questionnaire was used to interview pharmacy attendants. RESULTS: Of the 219 pharmacies surveyed, 62% reported more than 50 customers daily and 20% also sold items of general provision. Mean operating hours were 13. Only 24 (11%) had a visible license. On an average 3 attendants were employed per pharmacy. We interviewed one in each. Amongst the 219 interviewed, 77 (35%) were intermediate qualified and only 26 (12%) pharmacologically trained. Correct frequency of ORS administration was not known by 167 (76%) and 21% incorrectly suggested an anti-diarrhoeal preparation for viral diarrhoea in children. The knowledge of those with pharmacological training was significantly better. For respiratory tract infection in children approximately 60% did not know the correct dose of Paracetamol and Amoxicillin. Only 13 (6%) knew that Propanalol was contraindicated in hypertensive asthamatics. For Cotrimoxazole, metronidazole and lomotil only 40%, 21% and 15% respectively, were aware that these could not be dispensed without prescription. CONCLUSION: In the absence of trained pharmacists existing pharmacy attendants should be trained to improve drug-dispensing patterns.