LOPERAMIDE

Question 1

Drug class

Answer 1

anti-motility drug

Question 2

How does it work? (5)

Answer 2

• it is an agonist of the opioid receptors in the GI tract
• this increases non-propulsive contractions of the gut’s smooth muscle
• it reduces the peristaltic contractions
• the transit of bowel contents is slowed
• anal sphincter tone is increased

Question 3

What does slower bowl contents transit allow?

Answer 3

• more time for water absorption

- hence hardens stool

Question 4

Indications (3)

Answer 4

• diarrhoea
• IBS
• viral gastroenteritis

Question 5

Contraindications (4)

Answer 5

• avoid in acute UC
• avoid in C.difficle
• acute bloody diarrhoea - dysentery
• avoid in E.coli

Question 6

Why would you avoid in acute UC?

Answer 6

loperamide increases the risk of toxic megacolon

Question 7

Why would you avoid in c.difficile?

Answer 7

increases the risk of toxic megacolon

Question 8

Why would you avoid in acute blood diarrhoea?

Answer 8

this is a sign of a bacterial infection

Question 9

Why would you avoid in E.coli?

Answer 9

increases risk of Haemolytic-uraemic syndrome (HUS)

Question 10

Side effects (3)

Answer 10

• constipation
• abdo cramps
• flatulence

Question 11

Interactions

Answer 11

none

Question 12

Elimination

Answer 12

faeces