Evaluation of Anti-ulcer Potential of Sphenodesme involucrata var. paniculata (C.B. Clarke) Munir Leaves on Various Gastric Aggressive Factors
Parimelazhagan Thangaraj in Phytomedicine, 2020
Other medicines developed with gastroprotective action through mucosal protection are still to be mentioned; sulcralfate, bismuth, and subsalicylate are drugs that forms a gel-like mucus layer to inhibit the action of pepsin and also have inhibitory action against H. pylori; carbenoxolone, which increases gastric mucus production; and misoprostol, a synthetic analog of PGE1 that facilitates inhibition of gastric acid secretion, increased blood flow, enhanced mucus and bicarbonate secretion and, consequently, regulates gastric motility. Nonetheless, these medicines are accompanied with several side effects also, the usage of bismuth, subsalicylate, and sulcralfate may be hazardous to some of the patients in the form of dry mouth, headache, darkening of stools, and severe constipation. While, the misoprostol reported with after effects such as abdominal pain, vomiting and nausea, headache, and diarrhea during the course of treatment (Sung et al. 2010; Singh et al. 2018).
Immunosuppressants, rheumatic and gastrointestinal topics
Evelyne Jacqz-Aigrain, Imti Choonara in Paediatric Clinical Pharmacology, 2021
The mechanism of action of bismuth-containing agents (e.g. bismuth subsalicylate, bismuth subnitrate or bismuth subgallate) remains largely unknown. Studies have shown that bismuth subsalicylate inhibits intestinal secretion caused by cholera toxins and enterotoxic E. coli. In children with acute diarrhoea, studies have shown that treatment with bismuth subsalicylate reduces the frequency of unformed stools and the duration of diarrhoea [15]. Reports of encephalopathy occurring during ingestion of bismuth-containing compounds [16] led to prohibition of bismuth containing agents in France.
Diarrhea (Traveler's)
Charles Theisler in Adjuvant Medical Care, 2023
Bismuth subsalicylate (BSS), as in Pepto-Bismol, may be considered for any traveler to prevent traveler’s diarrhea. BSS has been studied using four divided doses of either 2.1 gm/day or 4.2 gm/day (with meals and at bedtime). A lower divided dose of 1.05 gm/day has also been shown to be preventive, although it is unclear whether it is as effective as the higher doses.4 Research shows that taking bismuth subsalicylate the day before traveling and continuing until two days after returning home reduces the risk of traveler’s diarrhea by up to 41%.5
The protective role of autophagy in nephrotoxicity induced by bismuth nanoparticles through AMPK/mTOR pathway
Published in Nanotoxicology, 2018
Yongming Liu, Huan Yu, Xihui Zhang, Yong Wang, Zhentao Song, Jian Zhao, Haibin Shi, Ruibin Li, Yangyun Wang, Leshuai W. Zhang
However, the potential applications of bismuth nanomaterials suggest the exposure and risk of bismuth on human and environmental health. Other than bismuth nanomaterials, bismuth salts such as colloidal bismuth subcitrate (CBS) and bismuth subsalicylate have been commonly used to treat peptic ulcers (Andrews et al. 2006; Marcus, Sachs, and Scott 2015). In addition, bismuth compounds such as bismuth vanadate, bismuth nitrate, and bismuth oxychloride have been applied as the raw materials for foundation in cosmetics. However, overdose of bismuth compounds can cause acute renal failure that has been mentioned by a numerous of clinical cases (Işlek et al. 2001). For example, during the treatment of Helicobacter pylori infections, CBS overdose has been reported to result in severe nephrotoxicity, such as necrosis in the proximal tubules (Leussink et al. 2001). In addition, bismuth oxybromide (BiOBr) NPs have been utilized in semiconductor industry, but BiOBr was found to be toxic to human skin keratinocytes (Gao et al. 2015). In spite of plenty case reports on bismuth nephrotoxicity, there were very limited studies to elucidate the mechanisms of bismuth nephrotoxicity in the cellular and molecular level.
Recommendations for the management of diarrhea with trofinetide use in Rett syndrome
Published in Expert Opinion on Orphan Drugs, 2023
Eric D. Marsh, Arthur Beisang, Timothy Buie, Timothy A. Benke, Brian Gaucher, Kathleen J. Motil
Other antidiarrheal medications to consider include bismuth [21] and cholestyramine. Families may prefer milder forms of antidiarrheal treatment such as bismuth subsalicylate for short-term use. Like other medications containing salicylate, it must be avoided in those with chicken pox exposure or illness [22]. Anticholinergic medication may be considered for severe cramping. Caregivers should consult with the individual’s gastroenterologist to address the use of other antidiarrheal medications and cramping. For unresolved diarrhea, the duration of antidiarrheal treatment and other management approaches may be determined through close collaboration with the individual’s gastroenterologist.
Is there a role for charcoal in palliative diarrhea management?
Published in Current Medical Research and Opinion, 2018
Helen Senderovich, Megan J. Vierhout
Although activated charcoal is not an obvious first line treatment for diarrhea management, another of its positive aspects is negligible side-effects5,23,24. Mrs X, Mr Y, and Mr Z were given charcoal as a second or third line treatment after failure of cholesteramine, loperamide, and octreotide, or risk associated with side-effects of these medications. There is a possibility for the onset of constipation25; however, this is unlikely in patients suffering from diarrhea. There are no known adverse effects or complications as compared to other diarrhea medications. As seen with our three case vignettes, no side-effects were experienced as a result of charcoal treatment. Commonly utilized loperamide may produce fatal side-effects, including serious cardiac consequences26, and inflammation or even perforation of both the small intestine and colon, especially when C. difficile colitis is a concern or may be suspected27,28. After long-term use of loperamide, Mrs X may have been experiencing some of these side-effects without being aware. Potential intestinal inflammation may have been further contributing to her diarrhea. In addition, Loperamide may worsen abdominal cramping and should not be used if there is bloody diarrhea. It should only be used in patients with painless diarrhea, as Loperamide was found to be no more effective than placebo at reducing pain and bloating29,30. Bismuth salicylate, for example, is another alternative, but it can cause delirium, psychosis, ataxia, myoclonus, and seizures31. Therefore, the safety of activated charcoal can be well-appreciated.