DIADIS TABLETS

Indications

• Acute poisoning
• Drug overdose
• Gastrointestinal decontamination

Dosage

Children: Refer to specific pediatric dosing recommendations based on the child's weight and the clinical situation.

Adults: Refer to specific guidelines depending on the type of poisoning and the clinical scenario.

Mechanism of action

Activated charcoal works through a process called adsorption, where toxins and drugs adhere to the surface of the charcoal particles due to electrostatic attractions and Van der Waals forces. This prevents the absorption of these substances in the gastrointestinal tract, allowing them to be excreted from the body.

Pharmacodynamics

The pharmacodynamic effects of activated charcoal are related to its ability to bind a wide range of substances. The efficacy of activated charcoal varies depending on the type and amount of the toxin or drug ingested, as well as the time elapsed since ingestion. Generally, activated charcoal is most effective when administered within one hour of ingestion of a toxic substance.

Pharmacokinetics

Activated charcoal is not absorbed by the gastrointestinal tract; instead, it remains in the gut, where it binds to ingested substances and promotes their elimination via feces. Its effects are dose-dependent, and it is typically administered as a single dose, although multiple doses may be considered in certain cases of severe poisoning.

Adverse effects

• Nausea
• Vomiting
• Diarrhea
• Constipation
• Abdominal pain
• Aspiration pneumonia (if inhaled)
• Electrolyte imbalances

Precautions

• Use with caution in patients with gastrointestinal obstruction
• Monitor for potential aspiration in patients with reduced consciousness
• Consider electrolyte levels in patients with significant diarrhea or vomiting

Pregnancy

Activated charcoal is generally considered safe for use in pregnancy, but consult a healthcare professional before use.

Breast-feeding

Activated charcoal is excreted in breast milk, use with caution and consult a healthcare professional.

Storage

Store in a cool, dry place away from direct sunlight. Keep out of reach of children.

Formulations

• Activated charcoal powder
• Activated charcoal capsules
• Activated charcoal tablets

Indications

• Acute diarrhea
• Non-specific diarrhea
• Acute gastroenteritis
• Adjuvant treatment for diarrheal diseases

Dosage

Children: Refer to specific product guidelines and local protocols, as dosing may vary depending on formulation and clinical situation.

Adults: Refer to specific product guidelines and local protocols, as dosing may vary depending on formulation and clinical situation.

Mechanism of action

Attapulgite exerts its therapeutic effects through a physical mechanism. It adsorbs toxins, bacteria, and other harmful substances in the gastrointestinal tract, thereby reducing irritation and improving stool consistency. The clay's large surface area enhances its adsorption capacity, allowing it to bind to various agents in the gut.

Pharmacodynamics

The pharmacodynamic effects of attapulgite are primarily related to its role as an adsorbent. By adsorbing excess fluids, it decreases the motility of the intestines and helps to normalize bowel movements. This effect is beneficial in alleviating symptoms associated with diarrhea. Additionally, its adsorption properties help to remove pathogens and toxins from the gut, contributing to its therapeutic efficacy.

Pharmacokinetics

Attapulgite is not absorbed systemically; it acts locally within the gastrointestinal tract. Its onset of action is generally within hours after administration, depending on the formulation and dosage. The clay is excreted unchanged in the feces, which means that its effects are limited to the gut without systemic exposure.

Adverse effects

• Constipation
• Nausea
• Vomiting
• Abdominal discomfort

Precautions

• Use with caution in patients with severe constipation or bowel obstruction
• Monitor for potential dehydration in patients with prolonged diarrhea

Pregnancy

Attapulgite is generally considered safe for use during pregnancy, however, it is advisable to consult a healthcare provider.

Breast-feeding

Attapulgite is considered compatible with breastfeeding, but it is recommended to consult a healthcare professional.

Storage

Store in a cool, dry place away from moisture.

Formulations

• Oral suspension
• Powder for oral solution
• Tablets

Indications

• Bacterial gastrointestinal infections
• Giardiasis
• Shigellosis
• Salmonellosis

Dosage

Children: Refer to the BNF for Children for specific dosing information based on the child's age and weight.

Adults: Refer to the BNF for specific dosing information based on the condition being treated.

Mechanism of action

Furazolidone and its related free radical products are believed to bind DNA and induce cross-links. This action makes bacterial DNA particularly susceptible to damage, leading to high levels of mutations in the bacterial chromosome, which interferes with DNA replication and protein production.

Pharmacodynamics

Furazolidone exhibits a broad antibacterial spectrum, effectively targeting major gastrointestinal pathogens. Its bactericidal activity is primarily due to interference with DNA replication and protein synthesis in bacteria, which helps reduce the potential for the development of resistant organisms.

Pharmacokinetics

Furazolidone is absorbed well from the gastrointestinal tract. It undergoes metabolism in the liver, and its elimination half-life is relatively short. The drug is primarily excreted in urine, and due to its potential side effects and interactions, monitoring of renal function may be necessary during treatment.

Adverse effects

• Nausea
• Vomiting
• Abdominal pain
• Headache
• Dizziness
• Allergic reactions
• Hemolytic anemia

Precautions

• Use with caution in patients with glucose-6-phosphate dehydrogenase deficiency due to potential for hemolytic anemia.
• Monitor for signs of peripheral neuropathy with prolonged use.
• Caution in patients with liver impairment.

Pregnancy

Furazolidone should be avoided during pregnancy due to potential teratogenic effects.

Breast-feeding

Use during breastfeeding is not recommended, as it may be excreted in breast milk.

Storage

Store in a cool, dry place, away from light. Keep out of reach of children.

Formulations

• Tablets
• Suspension

Mechanism of action

Furazolidone and its related free radical products are believed to bind DNA and induce cross-links. Bacterial DNA is particularly susceptible to this drug leading to high levels of mutations (transitions and transversions) in the bacterial chromosome. We are studying the development of unilateral malformations. Several chemicals elicit right sided limb defects both in vivo and in vitro. For example, nitroheterocyclics such as furazolidone (FZ) induce asymmetric defects in rat embryos in vitro. Potential mechanisms include asymmetric drug delivery; intrinsic difference between the cells of the left and right limbs; physiological asymmetry (e.g. in tissue oxygen), secondary to another primary asymmetry (e.g. in limb vasculature). In one series of experiments, we have investigated the role of an asymmetry in drug delivery and/or tissue oxygen. 10.3 days embryonic age rat embryos were explanted and cultured for two hours to allow 'recovery'. Embryos were then exteriorised (removal from yolk sac and amnion, retaining intact circulation) and cultured in the presence of 20 uM FZ with 5% O2 for 24h. The assumption was that exteriorisation would abolish any drug delivery or tissue oxygen asymmetry, by direct embryonic exposure to the medium. As previously described, FZ induced right sided defects (limb, eye and fore-brain) in 42% of intact yolk sac embryos. In contrast, exposure of exteriorised embryos to FZ induced a 34% incidence of abnormalities which were identical, but exclusively left sided. The results do not support a simple hypothesis that asymmetric drug delivery or tissue oxygen levels are responsible for the unilateral defects. We are investigating two potential explanations: a) Exteriorisation specifically reverses limb bud susceptibility, b) A secondary asymmetry e.g. mitochondrial maturity is altered by exteriorisation which then acts to invert the limb response. In a second series of experiments, we have also investigated a possible primary asymmetry in the development of the limb vasculature, using whole mount in situ hybridisation with a probe specific for early endothelial cell precursors (flk-1). The results are being analysed using confocal microscopy to image the limb vascular architecture.

Pharmacodynamics

Furoxone has a broad antibacterial spectrum covering the majority of gastrointestinal tract pathogens including E. coli, staphylococci, Salmonella, Shigella, Proteus, Aerobacter aerogenes, Vibrio cholerae and Giardia lamblia. Its bactericidal activity is based upon its interference with DNA replication and protein production; this antimicrobial action minimizes the development of resistant organisms.