Description of Drugs Used in Diarrhoea – PST04211 Basic Pharmacology

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NTA Level 4 • Semester 2 • PST04211

Description of Drugs Used in Diarrhoea

Basic Pharmacology • Source Session/Topic 22
Full source-text version: all educational wording from the extracted learning source is retained; only presenter/tutor metadata and web-layout noise are removed, while formatting is improved for readability.

Session 22: Description of Drugs Used in Diarrhoea

Total Session Time: 120 minutes

Prerequisites

• None

Learning Tasks

By the end of this session students are expected to be able to:

• List indications of drugs used in diarrhoea
• List contraindications of drugs used in diarrhoea
• Describe dose, dosage and course of drugs used in diarrhoea
• List side effects and adverse effects of drugs used in diarrhoea
• Describe interactions and precautions of drugs used in diarrhoea

Resources Needed:

• Flip charts, marker pens, and masking tape
• Black/white board and chalk/whiteboard markers
• Overhead projector and computer

SESSION OVERVIEW

Activity/

Step Time Content

Method

1 05 minutes Presentation Introduction, Learning tasks

Presentation/

2 20 minutes Indications of Drugs Used in Diarrhoea

Buzzing

Presentation/

3 20 minutes Contraindications of Drugs Used in Diarrhoea

Brainstorming

Dose, Dosage and Course of Drugs Used in

4 30 minutes Presentation

Diarrhoea

Presentation/ Side Effects and Adverse Effects of Drugs

5 20 minutes

Brainstorming Used in Diarrhoea

Interactions and Precautions of Drugs Used

6 15minutes Presentation

In Diarrhoea

7 05 minutes Presentation Key Points

8 05 minutes Presentation Evaluation

PST 04211 Basic Pharmacology NTA Level 4 Semester 2 Facilitator Guide

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SESSION CONTENTS

STEP 1: Presentation of Session Title and Learning Tasks (5 minutes)

READ or ASK students to read the learning tasks and clarify

ASK students if they have any questions before continuing.

STEP 2: Indications of Drugs Used in Diarrhoea (20minutes)

Activity: Buzzing (5 minutes)

ASK students to pair up and buzz on the following question for 2 minutes

• What are drugs are indicated in patient with diarrhea?

ALLOW few pairs to respond and let other pairs to add on points not mentioned

WRITE their response on the flip chart/board

CLARIFY and SUMMARIZE by using the content below

• Indications

o Loperamide is useful in symptomatic treatment of acute diarrhoea adjunct to

rehydration in adults and children over 4 years. It is also used for chronic diarrhoea in

adults only

o Zinc is used for treatment of acute diarrhoea and prevention of zinc deficiency and its

consequences, including stunted growth in children, and slow wound healing

o Oral rehydration salt is useful in replacement of fluid and electrolyte loss in diarrhoea

STEP 3: Contraindications of Drugs Used in Diarrhoea (20 minutes)

Activity: Brainstorming (5 minutes)

Ask students to brainstorm on the following question:

• What are contraindications of drugs used in diarrhea?

ALLOW few students to respond

WRITE their responses on the flip chart/ board

CLARIFY and SUMMARISE by using the content below

PST 04211 Basic Pharmacology NTA Level 4 Semester 2 Facilitator Guide

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• Loperamide is contraindicated in conditions where inhibition of peristalsis should be

avoided, where abdominal distension develops and in conditions such as active ulcerative

colitis or antibiotic-associated colitis

• Zinc is not contraindicated to any specific group of individual Oral rehydration is not

contraindicated to any specific group of individual

STEP 4: Dose, Dosage and Course of Drugs Used in Diarrhoea (30 minutes)

• Loperamide
o Acute diarrhea, 4 mg initially followed by 2 mg after each loose stool for up to 5
days. Usual dose 6–8 mg daily, maximum 16 mg daily, children 4–8 years, 1 mg 3–4
times daily for up to 3 days only, 8–12 years, 2 mg 4 times daily for up to 5 days
o Chronic diarrhea, in adults initially 4–8 mg daily in divided doses, subsequently

adjusted according to response and given in 2 divided doses for maintenance,

maximum 16 mg daily

o Fecal incontinence initially 500 micrograms daily, adjusted according to response,

maximum 16 mg daily in divided doses
• Zinc
o For diarrhea in malnourished or zinc-deficient children: 10-40 mg elemental zinc

daily

o For preventing and treating pneumonia in undernourished children in developing

countries, 10-70 mg/day
o For hypogeusia, (sense of taste is abnormal), 25-100 mg zinc
o For the eating disorder anorexia nervosa: 100 mg of zinc gluconate daily
o For treating stomach ulcers, zinc sulfate 200 mg three times daily
o For muscle cramps in zinc deficient people with liver disease zinc sulfate 220 mg

twice daily

o For osteoporosis, 15 mg zinc combined with 5 mg manganese, 1000 mg calcium, and
2.5 mg copper has been used
o For sickle cell disease, zinc sulfate 220 mg three times daily

o To increase growth and weight gain in children with sickle cell disease who have not

reached puberty, 10 mg elemental zinc per day
• Oral rehydration salt is given to fluid loss, usually 200–400 mL solution after every loose
motion; infant 1–1½ times usual feed volume; child 200 mL after every loose motion

PST 04211 Basic Pharmacology NTA Level 4 Semester 2 Facilitator Guide

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STEP 5: Side Effects and Adverse Effects of Drugs Used in Diarrhea

(15 minutes)

Activity: Brainstorming (5 minutes)

Ask students to brainstorm on the following question:

• What are the side effects and adverse drug reactions of drugs used in diarrhoea?

ALLOW few students to respond

WRITE their responses on the flip chart/ board

CLARIFY and SUMMARISE by using the content below

• Loperamide, abdominal cramps, dizziness, drowsiness, and skin reactions including

urticaria; paralytic ileus and abdominal bloating also reported

• Zinc, zinc cause nausea, vomiting, diarrhea, metallic taste, kidney and stomach damage,

and other side effects. On broken skin zinc may cause burning, stinging, itching and

tingling sensation

• ORS when given in excess may cause oedema and hyperchloraemic acidosis

STEP 6: Interactions and Precautions of Drugs Used in Diarrhoea

(15minutes)

• Loperamide increases plasma concentration of oral desmopressin
• Zinc decrease absorption of antibiotic in the GIT there by decreasing their effectiveness

For example:

o Zinc can attach to tetracyclines in the stomach. This decreases the amount of

tetracyclines that can be absorbed. Taking zinc with tetracyclines decrease the

effectiveness of tetracyclines. To avoid this interaction take zinc 2 hours before or 4

hours after taking tetracyclines

o Penicillamine interacts with zinc decrease how much penicillamine your body absorbs

and decrease the effectiveness of penicillamine

o Alcoholism, Long-term, excessive alcohol drinking is linked to poor zinc absorption

in the body

• Oral rehydration salt no known interactions since most components used are normal

elements in the body

PST 04211 Basic Pharmacology NTA Level 4 Semester 2 Facilitator Guide

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Step 7: Key Points (5minutes)

• Loperamide, zinc and ORS are indicated for diarrhea
• Excessive intake of oral rehydration salt may cause oedema
• Long term use of alcohol causes poor absorption of zinc
• Loperamide is used in management of acute and chronic diarrhoea
• Zinc interact and decreases absorption of some antibiotics

STEP 8: Evaluation (10minutes)

• What drugs are used in patient with diarrhea?
• What are the indications of drugs used in diarrhea?
• What are the contraindications of drugs used in diarrhea?
• What are the dose, course and dosage of drugs used in treatment of diarrhea?
• What are the side effects of drugs used in diarrhea?
• What the interactions and precautions are of drugs used in treatment of diarrhea?

PST 04211 Basic Pharmacology NTA Level 4 Semester 2 Facilitator Guide

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References

Robert, L. T., Gary ,C.Y., Gary,R.M, Barbara,G.W., & Michael, L. (2014).

Pharmacotherapy: A pathophysiologic approach (9th ed.). New York, McGraw-Hill

Education.

Ministry Of Health and Social Welfare. (2013). Standard Treatment Guidelines &

National Essential Medicines List Tanzania Mainland (4th ed.). Dar es salaam,

Tanzania government printers.

Sally S.R, & Jeanne C.S. (2000). Introductory Clinical Pharmacology (6th ed)

New York, Lippincott Williams and Wilkins.

School of Pharmaceutical sciences. (2011). Tanzania Pharmaceutical Handbook (2nd ed.).

Dar es Salaam, ARDHI University press.

The Royal Pharmaceutical Society of Great Britain. (2007). Martindale: The Extra

Pharmacopoeia (5TH ed). London, pharmaceutical press.

The Royal Pharmaceutical Society of Great Britain. (2009). British National

Formulary (59th ed). London, BMJ Group and RPS Publishing.

PST 04211 Basic Pharmacology NTA Level 4 Semester 2 Facilitator Guide

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