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(low-PEHR-uh-mide HIGH-droe-KLOR-ide)
Diar-aid, Imodium, Imodium A-D, Kaopectate II Caplets, Maalox Anti-Diarrheal, Neo-Diaral, Pepto Diarrhea Control,  Alti-Loperamide, Apo-Loperamide, Diarr-Eze, Novo-Loperamide, PMS-Loperamide Hydrochloride
Class: Antidiarrheal

 Action Slows intestinal motility, affects water and electrolyte movement through intestine, inhibits peristalsis, reduces daily fecal volume, increases viscosity and bulk density of stool, diminishes loss of fluid and electrolytes.

 Indications Control and symptomatic relief of acute non-specific or chronic diarrhea; reduction in volume of ileostomy output.

 Contraindications Pseudomembranous colitis due to antibiotic use; acute diarrhea associated with organisms that penetrate intestinal wall (eg, toxigenic Escherichia coli, Salmonella, and Shigella); conditions in which constipation should be avoided; bloody diarrhea; fever; acute ulcerative colitis (potential for toxic megacolon).

 Route/Dosage

Acute Diarrhea

ADULTS: PO 4 mg followed by 2 mg after each unformed stool; not to exceed 16 mg/24 hr. CHILDREN 8 TO 12 YR (> 30 KG): 2 mg tid. 6 to 8 YR (20 to 30 KG): 2 mg bid. 2 to 5 YR (13 to 20 KG): First day: 1 mg tid. May decrease to adjust for nutritional and hydration status after 24 hr; usually 0.1 mg/kg after each loose stool but do not exceed total first day dosing recommendations on any day.

Chronic Diarrhea

ADULTS: PO 4 to 8 mg qd or bid.

 Interactions None well documented.

 Lab Test Interferences None well documented.

 Adverse Reactions

CNS: Fatigue; drowsiness; dizziness. DERM: Rash. GI: Abdominal pain; distention or discomfort; constipation; nausea; vomiting; dry mouth.

 Precautions

Pregnancy: Category B. Lactation: Undetermined. Children: Not recommended for children < 2 yr. Use with caution in young children. Acute ulcerative colitis: Agents that inhibit intestinal motility or delay intestinal transit time may induce toxic megacolon. Discontinue if abdominal distention or other untoward symptoms occur. Hepatic impairment: Hepatic coma may be precipitated in patients with advanced hepatorenal disease or hepatic dysfunction.



PATIENT CARE CONSIDERATIONS

 Administration/Storage

  • Administer as ordered, usually after each unformed stool.
  • Store at room temperature.

 Assessment/Interventions

  • Obtain patient history, including drug history and any known allergies.
  • Assess frequency and consistency of stools.
  • Assess bowel sounds before and throughout course of therapy.
  • Monitor I&O, fluid and electrolyte balance and skin turgor for signs of dehydration.
OVERDOSAGE: SIGNS & SYMPTOMS
  Constipation, CNS depression, GI irritation

 Patient/Family Education

  • Instruct patient to record number and consistency of stools.
  • Inform patient that medication may cause dry mouth. Encourage patient to drink plenty of clear fluids to help prevent dehydration that may accompany diarrhea.
  • Advise patient to notify physician if diarrhea persists > 48 hr or if fever develops.
  • Inform patient that drug may cause drowsiness or dizziness and to use caution while driving or performing other tasks requiring mental alertness.

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