Laxatives and Antidiarrhoeal Agents 255postoperatively; bowel clearance before
radiography, endoscopy, labour or surgery.
It is contraindicated in intestinal obs-
truction, undiagnosed abdominal symptoms.
Dose: CREMALAX 5-10 mg HS.
SENNA
It is an anthraquinone laxative. It is not
active as such but after oral intake when it
reaches colon the bacteria liberate anthrones,
which is the active form. Active form acts on
myenteric plexus to increase peristalsis. It also
inhibits salt and water absorption in colon.
It is indicated in intestinal evacuation
for radiological examination and atonic
constipation.
Adverse effects include vomiting, nausea,
fixed drug eruptions, skin rash. It is contrain-
dicated in spastic constipation, electrolyte
imbalance, intestinal obstruction, lactation.
Dose: As powder 0.6-10 gm. HSANTIDIARRHOEAL AGENTS
Diarrhoea is defined as frequent passage of
liquid faeces with or without blood and
mucus. It occurs due to various causes,
infective or non infective.
The antidiarrhoeal agents can be
classified as in table 7.1.2.
Antidiarrhoeals are given for
symptomatic relief of diarrhoea. The first step
in treatment of acute diarrhoea is replacement
of fluid and electrolytes. If due to diarrhoea
there is severe dehydration, it requires
immediate hospitalization for IV fluid and
electrolyte replacement. Antidiarrhoeal
drugs are administered for obtaining
symptomatic relief in acute diarrhoea but
have untoward effects. Alongwith antidiar-
rhoeal drugs, antispasmodics are
administered in those patients who have
diarrhoea with abdominal pain.Table 7.1.2: Classification of antidiarrhoeal agents.
I. Rehydrating solutions: Containing NaCl, KCl, NaHCO 3 (for parenteral administration) and sodium
chloride, potassium chloride, sodium citrate and glucose as oral formula (ORS).
II. Absorbents & bulk forming agents
Kaolin 2-4 g/day
Pectin 100-300 mg/day
Psyllium 8-16 g/day
Ispaghula 8-16 g/day
Methyl cellulose 4-6 g/day
III.Antimotility & antisecretory drugs
Codeine 30-60 mg TDS
Loperamide (LOPAMIDE) 4-16 mg/day
Diphenoxylate with atropine (LOMOFEN) 5 mg QID
Sulfasalazine (SALAZOPYRIN) 1-3 g QID
Mesalazine (MESACOL) 2-4 g/day
IV.Antimicrobial drugs
Details are given in chapter ‘Chemotherapeutic agents’.