FAMILY MEDICINE FOR SYMPTOMATIC RELIEF

 I. DRUGS USED IN DIARRHEA:-

Diarrhea is characterized by the frequency passage of liquid or semisolid stool and may be accompained by abdominal pain and blood and mucus.

 

CAUSES OF DIARRHEA:-

• Diarrhea in children is mostly caused by Rota virus. 
• Specific diarrhea, cholera, shiggela, typhoid, allergic disorder. 
• Certain food item like ice cream, cheese, rasmalai chocolate and soft drink can cause diarrhea. 
• Some antibiotics (ampicillin & Tetracyline) and Purgatives may cause diarrhea. 

 

3 POINTS:-

• Increase formation of fluid 
• Increase formation of gut 
• Bacterial overgrowth 

 

TREATMENT OF DIARRHEA:-

The problem of diarrhea is dehydration — (Loss of fluids).

 

II. ANTIMOTILITY DRUGS IN DIARRHEA:-

Rx. DIPHENOXYLATE (LOMOTIL)

• This drug reduces the frequency of stools.
• Available combination (Lomotil containing a trophine 0.025 mg and diphenoxylate 2.5 mg)

 

ADR IN CHILDREN:-

• Dryness of mouth 
• Blurring of vision 
• Urinary retention 
• Distension of abdomen 
• Respiratory depression 
• Coma

 

III. Rx. LOPERMAIDE:-

(Lopamide, Ridol,  and Immodium 2 mg)

• More potent than diphenoxylate
• Average daily adult dose is 4 to 8 mg 

 

ADR:-

• Abdominal cramps
• Skin rashes 

 

IV. Rx. RACECADOTRIL:-

(Redotril, Raceloc, Zedott cap 100 mg)

• This is newer drug which reduces fluid secretion and its loss. 
• Used in viral and watery diarrhea and diabetes. (Dose 100 mg – 3 times a day)
• Safer than diphenoxoxylate and codeine 
• Marked formulation 

 

Rx. RACEGYL -OC (FDC)

Rx. RACECODOTRIL WITH OFLOXACIN 200 MG

ADR:-

• Nausea 
• Thirst 
• Giddiness 
• Headaches 

 

V, ISABGOL (SAT ISABGOL):-

• Generally used for treatment of constipation 
• Effective in mild diarrhea 
• Zinc Sulphate (Rx. Zioral Tab 20 mg)
• Zinc Asetate (Rx. Zincrisz 20 mg/5ml – for kids 

 

DRUGS USED IN DYSTENTRY:-

1. Drugs used for overcoming diarrhea due to infection. 
2. It contains furazolidone, sulfonanide, and antibiotic. 
3. Furazolidone (Rx. Furoxone – 100 mg tab/ 25mg-ml Religy-F
4. Usual adult dose is 100 mg to take 3 times a day after meals. 
5. Children require 5 to 10 mg./kg body weight dose in 3-4 divided dose. 

ADR:-

• Nausea 
• Vomiting
• Headache 
• Dizziness 
• Skin rashes 

 

COLISTIN SULPHATE (Rx. WELAMYCIN):-

Colistin sulphate is an antibiotic used for diarrhea infants.

 

AMPICILLIN (Rx. AMPICILLIN & Rx. CAMPICILLIN):-

• Used in bacillary dysentery 
• Nalidixic acid (Rx. GRAMONEG NEGADIX TAB 500 mg, 1 g/300 mg/5ml
• Used in infective diarrhea. (Rx .RIFAGUT 200 MG TAB)

 

ROLE OF PRE & PROBIOTIC IN A ANTIBIOTIC ASSOCIATED DIARRHEA:-

1. Prebiotic is a specialized micro-organism that nourishes the good bacteria present in the large bowel or colon. 
2. Probiotics are live bacteria found in yogurt, curd, and dairy products and pills. 
3. Symbiotics contain prebiotics and probiotics. 

 

DRUGS FOR DYSENTERY:-

Divided into 3 categories according to their effectiveness.

Rx. METRONIDAZOLE (FLAGYL, METROGYL, UNIMEOZL):-

These drugs are used in ambebiasis

Dose – 400 to 800 mg should be taken 3 times. 

Rx. TINIDAZOLE:-

• This is related to metronidazole but has the advantage of a longer duration of actions. 
• Dose is 600 mg twice a day for 5 days. 

 

Rx. SECINDAZOLE, ORNIDAZOLE, SATRAIDAZOLE, NITAROXANIDE, DILOXANIDE, AND FLROATE.

 

DRUGS FOR VOMITING AND NAUSEA:-

CAUSES OF VOMITING:-

• Indigestion 
• Unpleasant smell
• Unpalatable food 
• Drugs/Chemicals 
• Travel sickness 
• Pregnancy 

 

PATHOLOGICAL CAUSES OF VOMITING:-

• Food poisoning 
• Acute abdominal emergencies like appendicitis or obstruction of intestines. 
• Diseases of gall bladder 
• Disease of pancreas 
• Diseases of liver, peritoneum 
• Acute infective illness like hepatitis 
• Cholera 
• Malaria 
• Meningitis 
• Heart diseases like myocardial infraction. 
• Symptom of brain stroke and brain tumors 

 

DRUGS IN SYMPTOMATIC MEDICINES:-

Very effective in preventive vomiting. 

Rx. PrROCH LORPERAZINE:-

Average dose is 5-10 mg

Rx. TRIFLUPROMAZINE:-

Average dose is 10-25 mg dose

Rx. PROMETHAZINE:- 

Average dose is 10-20 mg bid/tid

Rx. DOXYLAMINE:- 

Average dose is 10 mg and Vitamin B6 10 mg)

Prescribed for nausea and vomiting of pregnancy

Rx. DOMPERIDONE :-

Average dose is 10 mg, 1 mg, ml syp, tab-DT-5. 10 mg, 30 mg)

• Acts on brain/stomach 
• Safe in patients suffering from Parkinson’s disease 
• Combined with RABEPRAZOLE/OMEPRAZOLE for GERD
• Usual dose is 20 to 40 mg t.i.d or q.i.d 
• S/E headache, dryness of mouth, drowsiness, breast enlargement and pain. 

 

DRUGS USED DUE TO ANTI-CANCER THERAPY:-

Rx. GRANESETRON:-

Average dose is 1 mg to 2 mg. Given twice on day 1 of chemotherapy.

Rx. RAMOSTERON:- 

Average dose is 0.1 mg tab

Rx. PALANOSTERON:-

Average dose is 0.25 mg for 7 days.

Rx. APREPITANT:- 

Average dose is 80 mg to 125 mg. On the first day give 125 mg. Dexamethasone 1 hour before therapy.

On the 2nd and 3rd day – give 80 mg.

Rx. DOXYLAMINE:-

Average dose is 10 mg. Give for few days. It is used for severe vomiting.

 

Rx. PROMETHAZINE THEOCLATE:-

Average dose is 25 mg. It is used for:-

• Vomiting motion sickness 
• Taken hour before journey 
• Combined with paracetamol 2.5 mg to 5 mg to prevent nausea and vomiting.

 

DRUGS USED IN VERTIGO:-

DISEASES OF INTERNAL EARS:-

• Labrinthitis
• Vestibulutis 
• Meniere’s Disease 

 

DISEASES OF BRAIN:-

• Brain stem strokes
• Neuroma 
• Cerebellar disease 
• Multiple Sclerosis 
• Cervical Spondylsis 
• Vertigo associated with migraine 

 

MEDICINES FOR VERTIGO:-

Rx. BETAHISTINE:-

Dose is 8 mg to 16 mg tab. Commonest drug in vertigo and giddiness. 

A/E – Headache, nausea, weight loss, skin allergy.