Anti-Diarrheals &

Anti-Haemorrhoidals
 OBJEKT
IF
• Menerangkan definisi dan
tindakan ubat ‘Anti-Diarrheal
& Anti-Haemorroidals’.
• Menerangkan kesan
sampingan ubat.
• Menyatakan contoh, dos dan
cara pemberian ubat.
• Menyatakan indikasi dan
kontraindikasi ubat.
• Menyatakan nasihat yang
relevan semasa penggunaan/
pemberian ubat.
Anti-Diarrheals
 Diarrhea
• Dicirikan oleh najis berair (najis)
yang disebabkan oleh peningkatan
pergerakan peristalsis usus.
• Najis bergerak sangat cepat, jadi
badan tidak dapat menyerap air..
• Air masih dalam najis & menjadikan
ia berair.
 Anti-Diarrheals

• Ubat yang digunakan

untuk merawat
diarrhea dan
mencegah dehidrasi.
 Tindakan
• Ubat ini mengurangkan
pergerakan peristalsis dalam
usus.
• Maka feces akan bergerak
dengan perlahan dan lebih
banyak air akan diserap oleh
sel-sel badan.
• Ini menyebabkan feces
kehilangan air & menjadi
semi-pepejal (to original
form).
 General Indication

• Merawat diarrhea
• Merawat dehidrasi
(bersama-sama ORS)
Jenis-jenis Anti-Diarrheals

• Penyerap
• Melambatkan motiliti
Penyerap
 Tindakan

• Meningkatkan ketelapan
usus terhadap air.
• Maka penyerapan air dari
feces meningkat.
 Contoh ubat

• Kaolin Mixture
 1. Kaolin Mixture

Dose

• 15ml q 8 hr PO
Melambatkan
Motiliti
 Tindakan
• Melambatkan motiliti usus
dengan tindakan terus ke
atas otot-otot ‘circular’ dan
‘longitudinal’ pada dinding
usus.
• Maka feces lambat bergerak
& lebih banyak air akan
diserap.
 Contoh ubat

• Diphenoxylate HCl with

atropine sulphate (Lomotil)
• Difenoxin HCl with atropine
(Motofen)
• Loperamide HCl (Imodium)
1. Diphenoxylate HCl with
atropine sulphate
(Lomotil)
Category: B
 Dose
• Adult:
• Initial: 4 tabs followed by 2
tabs q 6 hr
• Until diarrhea controlled
• Peads:
• 4-8 yrs: 1 tab tid/d
• 9-12yrs: 1 tab qid/d
2. Difenoxin HCl with
atropine (Motofen)

Category: B
 Dose

• Initial: 2 tabs PO
• Then 1 tab after each loose
stool
• Max: 8mg/d (Not > 2 days)
3. Loperamide HCl
(Imodium)
Category: B
 Dose
• Adult:
– Initial: 4mg PO
– Then 2mg after each loose/
unformed stool (up to 5 days)
– Usual dose: 6-8mg/day
– Chronic diarrhea: Initial: 4-
8mg/day (divided dose)
– Max: 16mg/d
 Kesan sampingan

• Anorexia
• Nausea & Vomiting
• Abdominal pain &
distention
• Constipation
• Dizziness & sedation
• Headache
• Drug dependency
• Paraesthesia
• Paralytic ileus
• Tachycardia
• Flushing
• Rash
• Dry mouth
 Contraindications

• Allergic to drugs
• Ulcerative colitis
• Paralytic ileus
• Unknown abdominal pain
• Peads < 2 yrs (Lomotil &
Loperamide)
• Diarrhea caused by harmful
microbes:
– Escherichia coli
– Salmonella
– Shigella
 Cautious
• Severe hepatic impairment
• Inflammatory bowel disease
• Down’s Syndrome
• Peads < 6 yr (Imodium)
• Pregnancy
• Lactation
 Interactions
• Alcohol, Anti-histamine,
Narcotics, Sedatives &
Hypnotics
• Additive CNS depression
• Anti-depressants & Anti-
histamine
• Additive anti-cholinergic
effects
• MOAIs
• Increase risk of hypertensive
crisis
 Soalan
1. Berikan definisi Anti-diarrheals?
2. Terangkan cara tindakan Anti-
diarrheals?
3. Senaraikan contoh ubat Anti-
diarrheals?
4. Nyatakan kesan sampingan dan
kontraindikasi ubat Anti-
diarrheals?
 Anti-
Haemorrhoidals
 Haemorrhoids

• Swelling and
inflammation of veins
in the rectum and anus.
Anti-Haemorrhoidals

• Ubat yang digunakan

untuk merawat
haemorrhoids atau
buasir.
 Tindakan

• Mengurangkan
– Inflammasi dan irritasi pada
dinding anus
– Kesakitan dan rasa tidak
selesa pada bahagian rektum
dan anus
 General Indication

• Merawat simptomatik
haemorrhoids
(buasir).
 Jenis-jenis Anti-
Hemorrhoidal
• Soothing agents with
antiseptic & vasoconstrictor
properties
• Rectal corticosteroids
• Local anesthetic with
corticosteroids
Soothing agents
with antiseptic
&
vasoconstrictor
properties
 Tindakan

• Relieves pruritus, burning,

soreness in patients with
hemorrhoids.
 Contoh ubat
• Bismuth subgallate, Benzyl
Benzoate suppository
(Anusol Supp)
• Diosmin 450mg +
Hesperidin 50mg tablet
(Daflon 500)
1. Bismuth subgallate,
Benzyl Benzoate
suppository
(Anusol Supp)
Category: C
 Dose

• 1 supp to be inserted into

rectum (om and on) after
defecation.
• Do not use more than 7
days
 2. Diosmin 450mg +
Hesperidin 50mg (Daflon
500)
Category: A
 Dose

• Acute attack: 6 tabs/d for 1st

4 days
• Then 4 tabs/d (2 divided
doses) for 3 days &
• 2 tabs thereafter
 Kesan sampingan
• Local irritation

Contraindications

• Allergic to drugs
 Cautious
• Long term use
• Pediatrics

Interactions
• Not found
 Rectal
corticosteroids
 Contoh ubat

• Hydrocortisone
suppositories
 1. Hydrocortisone
suppositories
Category: B

Indication
• Relief of inflammation
 Dose
• 1 supp to be inserted into
rectum (om and on) after
defecation.
 Kesan sampingan
• Local irritation

Contraindications

• Allergic to drugs
• Bowel obstruction
 Cautious
• Long term use

Interactions
• Not found
Local anesthetic
with
corticosteroids
 Contoh ubat
• Lignocaine, Aluminum
acetate, Zinc oxide,
Hydrocortisone Suppository
(Xyloproct supp)
• Tribenoside, Lignocaine
Suppository (Proct -
glyvenol supp)
 Indication

• Anorectal pain
• Pruritus
• Inflammation
• Irritation
1. Lignocaine, Aluminum
acetate, Zinc oxide,
Hydrocortisone
Suppository (Xyloproct
supp)
Category: B
 Dose
• 1 supp to be inserted into
rectum (om and on) after
defecation.
• Not for prolonged use
2. Tribenoside, Lignocaine
Suppository (Proct -
glyvenol supp)
Category: A
 Dose
• 1 supp to be inserted into
rectum after defecation.
 Kesan sampingan
• Dry skin
• Pruritus
• Irritation
• Transient burning & stinging

Contraindications
• Allergic to drugs
 Cautious
• Peads < 12 yr
• Sepsis in anorectal region

Interactions
• Other local anesthetics
– Additional risk of systemic
toxicity
 Soalan
1. Beri definisi dan terangkan cara
tindakan ubat Anti-
haemorrhoidals?
2. Senaraikan jenis-jenis ubat Anti-
haemorrhoidals beserta dengan
contoh?
3. Nyatakan kesan sampingan dan
kontraindikasi ubat Anti-
haemorroidals?