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The drugs in this group are used for overcoming diarrhea due to infection. These include furazolidone, sulfonamides, and antibiotics. Furazolidone (Furoxone) This drug has been found to be effective in controlling diarrhoea due to a large variety of micro-organisms. An important feature is that micro-organisms do not develop resistance to this drug. It is a valuable agent in the treatment of gastro-enteritis and infections which are resistant to sulfadiazine, tetracycline or chloramphenicol. It is also available in combination with metronidazole - an antiamoebic drug. The usual adult oral dose is 100 mg, four times a day. Children require 5 to 10 mg/kg body weight in 3 to 4 divided doses (Furoxone 25 mg/ml) Adverse Effects: Adverse effects of this drug are minimal. It may cause nausea, vomiting, headache, and in rare cases, allergic reaction in the form of skin rashes. Precautions The drug should not be taken on an empty stomach. If severe nausea or vomiting are experienced, doses should be reduced or drug withdrawn. The drug should be stopped if symptoms of allergic reaction occur. Neomycin, Colistin Sulfate (Walamycin) Neomycin is an antibiotic found to be of special value in the treatment of diarrhea in infants because of its local action. It is usually given in combination with other non-specific antidiarrhoea drugs. Ampicillin (Ampicillin Campicillin) Nowadays ampicillin is a drug of choice in the treatment of bacillary dysentery Norfloxacin (Norflox, Uroflox) It is a fluoroquinolone which is effective against microbes causing diarrhoea and urinary infection. Usual dose is 400 mg twice a day. Manufacturers forbid its use in children. Unfortunately a large number of preparations contain pediatric syrups/dispersable tablets which have been used. This drug can cause cartilage damage. Adverse effects are nausea, vomiting, headache, dizziness, dry mouth, loss of sleep and convulsions. Its use should be restricted. Drugs Used in Severe Diarrhea In severe types of dirrhea and in diarrhoea associated with vomiting, immediate attention is necessary. Besides the use of powerful drugs, fluid and electrolyte balance should be corrected to avoid dehydration. Dehydration is characterized by hot and dry skin over the abdomen, dry tongue and lips, sunken eyeballs, and shock. In such cases, fluids should be infused through an intravenous drip and anti-spasmodics and antibiotics should be given. A number of drugs are available for the treatment and shown in table below: Drugs Used in Irritable Bowel Syndrome Irritable bowel syndrome (IRS) is a common functional disorder of intestines. A patient with IBS has complaints such as abdominal pain, constipation or diarrhea. Investigation reveal normal structures. Many patients are treated unnecessarily with antiamoebic and antibacterial drugs. Treatment depends on the nature of complaints. Many patients improve with eating more fibres (Isabgol husk may be added). In others, fibre rich diet increases gaseousness and bloating. Two types of drugs are useful in this disorder: Those who have loose stools can benefit from diphenoxylate or loperamide. Antidepressants and diazepam also helps. Those who have constipation require drugs like cisapride, mosapride and tegaserod. Tegaserod (TEGIBS 2 mg, 6 mg cap) is a new drug available in India. It is used in IBS when constipation is the main complaint (spastic colon).
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