Loperamide chemical structure
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Imodium

Loperamide, usually as hydrochloride, is a drug effective against diarrhea resulting from gastroenteritis or inflammatory bowel disease. In most countries it is available generically under brand names such as Lopex®, Imodium®, Dimor® and Pepto® Diarrhea Control. more...

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Mode of action

Loperamide is an opioid receptor agonist and acts on the mu opioid receptors in the myenteric plexus large intestines; it does not affect the central nervous system like other opioids.

It works by decreasing the activity of the myenteric plexus which decreases the motility of the circular and longitudinal smooth muscles of the intestinal wall. This increases the amount of time substances stay in the intestine, allowing for more water to be absorbed out of the fecal matter. Loperamide also decreases colonic mass movements and suppresses the gastrocolic reflex.

Loperamide does not cross the blood-brain barrier and has no analgesic properties or addictive potential. Tolerance in response to long-term use has not been reported.

Contraindications

Treatment should be avoided in the presence of fever or if the stool is bloody. Treatment is not recommended for patients who could suffer detrimental effects from rebound constipation. If there is a suspicion of diarrhea associated with organisms that can penetrate the intestinal walls, such as E. coli O157:H7 or salmonella, loperamide is contraindicated.

Side-effects

Side effects can include the following: drowsiness, constipation, abdominal pain or discomfort, dry mouth, fatigue, and in rare cases toxic megacolon.

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Backpackers, beware
From Shape, 5/1/04 by Dinah Erasmus

If you're headed to the trails for an extended trip this season, be prepared for ailments ranging from diarrhea to tick bites. Here, David Boulware, M.D., of the Division of Infectious Disease and International Health in the Department of Medicine at the University of Minnesota offers advice on the best ways to avoid and treat some common wilderness-hiking woes.

* AILMENT Diarrhea

PREVENTION Always disinfect water with iodine or a filtration system. Wash or disinfect your hands with soap and water or alcohol-based hand sanitizers, and clean cookware and utensils thoroughly with soap and water.

TREATMENT Stay hydrated; take Imodium or Pepto-Bismol as needed.

SEE A DOCTOR IF diarrhea is accompanied by a fever, bloody stool and/or lasts more than two weeks.

* AILMENT Foot blisters

PREVENTION Buy footwear that fits well and break it in prior to your trip; stop friction on "hot spots" immediately by taking a break and applying tape or padding.

TREATMENT Tape affected area or use blister pads, such as Spenco 2nd Skin Blister Pads or Band-Aid Advanced Healing Blister pads.

SEE A DOCTOR IF a blister becomes infected.

* AILMENT Joint pain, body and back aches

PREVENTION Travel lighter: Your backpack shouldn't be more than 15 percent of your body weight. Rest regularly to avoid overuse injuries.

TREATMENT Rest, compress and elevate sore joints. Ice them if possible, or take an over-the-counter nonsteroidal anti-inflammatory such as ibuprofen.

SEE A DOCTOR IF the pain persists or worsens, which could indicate an overuse injury such as a severe strain or sprain.

* AILMENT Tick bites

PREVENTION Wear long pants and high socks; pre-treat clothes with permethrin, an insecticide found at outdoor adventure stores; check body regularly.

TREATMENT If the tick is still on you, remove it immediately by grasping its head with tweezers and pulling it straight away from your skin.

SEE A DOCTOR IF you experience symptoms of Lyme disease or Rocky Mountain spotted fever (RMSF). About three days or more after a bite, symptoms of either disease may include rash, fever, severe headaches, muscle aches, chills and extreme exhaustion. If untreated, Lyme disease can cause arthritis and other painful afflictions, while RMSF can lead to serious illness or death.--A.V.

COPYRIGHT 2004 Weider Publications
COPYRIGHT 2004 Gale Group

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