ANTI DIARE

Dharma Permana, PhD, Apt

Anti Diare
In diarrhea, the food and fluids you ingest
pass too quickly or in too large an amount or both through your colon

The most common causes of diarrhea include:

Viruses. Common viruses that cause diarrhea are the Norwalk virus, cytomegalovirus, viral hepatitis and the herpes simplex virus. Rotavirus is the most common cause of acute childhood diarrhea. Viral diarrhea spreads easily. Bacteria and parasites. Contaminated food or water can transmit bacteria and parasites to your body. - Parasites such as Giardia lamblia and cryptosporidium can cause diarrhea. -Common bacterial causes of diarrhea include campylobacter, salmonella, shigella, vibrio cholerae and Escherichia coli. This type of diarrhea can be common for people traveling to developing countries.

Common causes of travelers diarrhea

Bacteria (70%)
E. coli Salmonella spp Campylobacter jejuni Shigella spp Vibrio cholerae and other spp

Parasites

Viruses

Giardia lamblia Noro-viruses Cryptosporidium parvum Rotavirus Entamoeba hystolitica Cyclospora cayetanensis

Other causes of diarrhea:

Lactose. A sugar found in milk and milk products, lactose is a common cause of diarrhea in some people. Medications. Diarrhea can also be a side effect of many medications, particularly antibiotics. Antibiotics destroy both good and bad bacteria, which can disturb the natural balance of bacteria in your intestines. This disturbance sometimes leads to an infection with bacteria called Clostridium difficile, which can also cause diarrhea. Artificial sweeteners. Sorbitol and mannitol, artificial sweeteners found in chewing gum and other sugar-free products, can cause diarrhea in some otherwise healthy people. Surgery. Some people may experience diarrhea after undergoing abdominal surgery or gallbladder removal surgery. Other digestive disorders. Chronic diarrhea has a number of other causes, such as Crohn's disease, ulcerative colitis, celiac disease and irritable bowel syndrome.

Obat obat anti diare

Oralit Adsorben dan Pembentuk masa Anti Spasmodik/ anticholinergic Anti Motilitas Anti Microbabakteri, amuba

Oralit
Pertolongan pertama pada diare Komposisi oralit
Glukosa anhidrat 4 NaCl 0,7 Na sitrat dihydrat 0.58 aqua ad 200 ml

- Oralit tidak menghentikan diare, tetapi mengantikan

cairan tubuh yg hilang bersama tinja - Tiap kali BAB diberi Oralit Dehidrasi ringan/ sedang < 1th min 300 ml, 1-4 th min 600ml 5-12 th min 1,2 L dan Dewasa 2,4 L

Adsorben dan Pembentuk masa

Adsorben
Norit tdk diserap usus, eksresi melalui tinja -menyerap toksin Pembentuk Masa Tinja -Kaolin -Attapulgit tdk diserap usus, eksresi melalui tinja

Anti Spasmodik
Menghambat peristaltik usus dan lambung
Penghambatan thd asetilkolin eksogen ( ester kolin) - Bekerja pada reseptor muskarinik anti muskarinik -Mudah diserap, eksresi melalui ginjal (sebagian dlm bentuk asal ) -Efek sampingmulut kering, dilatasi pupil dan rasa haus

Obat obat anti spasmodik

Atropin0,25mg dan 0,5 mg Inj dan tab Ekstrak belladon10 mg/tab Hyosin n-butil bromida 10 mg/tab dan
20mg/tab Papaverin HCl 40 mg/tab

Anti Motilitas
Memperlambat motilitas saluran cerna dgn
mempengaruhi otot sirkuler dan longitudinal usus decreases colonic mass movements and suppresses the gastrocolic reflex Berkaitan dgn reseptor opioid u reseptor Kontraksi sal cerna berkurang

Obat obat anti motilitas

1.Loperamid (Imodium) Tidak diserap baik secara oral ekresi ( tinja) Loperamide is a synthetic anti-diarrheal indicated for the control and symptomatic relief of acute nonspecific diarrhea and of chronic diarrhea associated with inflammatory bowel disease. Sediaan tab 2mg & sirup 1 mg/5 ml Tdk dianjurkan utk anak2 Side effects: constipation; difficulty breathing , dizziness , drowsiness
2.Codein Phospat Tdk dianjurkan utk anak2 3.Morfin

Zinc and Diarrhea

In May 2004, WHO/UNICEF issued a joint
statement recommending the use of zinc, an essential micronutrient for human growth, development and maintenance of the immune system, and a new formulation oral rehydration solution (ORS), with reduced levels of glucose and salt, as a two-pronged approach to improved case management of acute diarrhea in children. WHO and UNICEF recommend 20 mg of zinc per day for ten -14 days for infants and children, 10 mg for infants under six months of age.

ZINC SUPPLEMENTS REDUCE THE SEVERITY AND

DURATION OF DIARRHOEA

Twelve studies examined the impact of zinc supplements

on the management of acute diarrhoea. Eleven of these showed a reduction in the duration of the diarrhoeal episode; the reduction was statistically significant. The data shows that zinc supplementation during and until cessation of diarrhoea (either syrup containing 20 mg of elemental zinc per 5 ml, or tablets of 20 mg zinc such as zinc sulphate, gluconate or acetate) has a significant and beneficial impact on the clinical course of acute diarrhoea, reducing both its duration and severity.

Diarrheal Disease Control website at www.eddcontrol.org,

Pharmacokinetics of Zinc
Zn and its salts are poorly absorbed from GIT
Zinc is absorbed and is widely distributed throughout the body and excreted mainly in the feces and only traces are found in the urine since kidney has little role in regulating body Zn content. Endogenous Zn be reabsorbed in ileum and colon creating enterohepatic circulation of Zn

Zinc is primarily stored in muscle, bone,Skin, Kidneys,

Liver, Pancreas,retina, prostate

Zn supplements is usually administered 1 hour before or

2 hours after food. In the presence of gastric irritation Zn has to be given with food. Read more:

SIDE/ADVERSE EFFECTS OF ZINC:

-Gastrointestinal abnormalities - Dyspepsia - Epigastric pain & heart burn - Nausea - leucopenia (fever, chills, sore throat) - Neutropenia (continuing ulcers & sores in mouth and throat) - Sideroblastic anemia (unusual weakness/tiredness) -Zinc overdose - Hypotension

Thank you