[sabriel]

Hi,Just hoping someone here may be able to tell me what Antiperistaltic means?

I found a definition for Anticholinergic being: Anticholinergics are used to reduce both gastric acid and other secretions in the stomach, and to reduce cramps or spasms in the muscles of your stomach, intestine and urinary tract. Also used to relieve the pain of stomach and bowel cramps by helping your digestive system to relaxBut I have not been able to find a definition for 'Antiperistaltic' anywhere, even on the numerous medical sites I have tried.Just that I noticed this term used in the 'drugs' area of the Ibs.org site (particularly in relation to Lomotil tablets) and wondered what it means.Maybe we could introduce a glossary of technical terms on the site to help less technical people (like me)understand these terms?

Thanks.

 

[AD]

The root word "peristalsis" refers to the movements and contractions of the muscles of the colon and small intestine. The prefix "anti" would indicate that the medication halts or stops the movement.Obviously, the drug just makes the whole gut more "still" if it is moving too much. The class of drugs would apparently be used only to treat IBS-D and cramping.

 

[flux]

No, peristalsis refers to propagating contractions away from the mouth (aborad). Antiperistalsis therefore refers to propagating contractions toward the mouth (orad). Vomiting utilizes antiperistalsis.

 

[sabriel]

Ok, I think I understand now then, correct me if I am wrong:Re the term 'antiperistaltic' and its application to Lomotil tablets, ok so Lomotil is Diphenoxylate and Atropine. So the Diphenoxylate part is the antidiarrheal and the Atropine is the antiperistaltic?My conclusion then, is that the Atropine is the ingredient that is added to discourage overdosing by having an emetic (antiperistaltic) effect? In other words, if you overdose on it it will make you vomit?Quote from the Consumer info: "A subtherapeutic amount of atropine sulfate is present to discourage deliberate overdosage."I hope that is right, and that if it is the info will also be of help to others.Thanks.

 

[flux]

quote:Re the term 'antiperistaltic' and its application to Lomotil tablets

I would say that the person who wrote this was using AD's definition of antiperistalsis, which not really correct. In other words, Lomotil is not antiperstaltic. Niether is atropine. In fact, atropine is anti anti-peristaltic.I now see where it says that. In fact, the PDR uses the term like this too. Pharmacologists seem to use the term to mean something different from the way gastroenterologists do. I suppose we can edit the dictionary

In addition, Lomotil probably works at least to some degree by increasing segmentation contractions which interfere physically with peristalsis. It probably also limits secretion in the gut.

quote:Atropine is the ingredient that is added to discourage overdosing by having an emetic (antiperistaltic) effect?

It wouldn't make you vomit, but there are other side effects like blurred vision and dry mouth.

 

[trbell]

my vague understanding is that there are two peristaltic movemnts - a short one and a longer wavelike one and one of them. One of these two is a mystery at this point in time.I don't think it would be a bad idea to have a listing of terms, but I also think it would help if whoever did it had some education as a medical educator? It's frustrating for me to read replies where the person is essentially correct but may have an oversimplified understanding. But I'm not an expert - only I know enough to know they don't have the whole story even though i don't know the whole story myself.tom

 

[sabriel]

Ok, so now I am more confused than ever! The definition for Lomotil tablets that said they are an antiperistaltic came from here:http://www.ibsgroup.org/main/drugs.html but the strict definition (from the link on the above page, is as below, so does that mean that they are not an antiperistaltic at all then? If so shouldn't the http://www.ibsgroup.org/main/drugs.html page be updated? I am really interested in knowing just what the medications I take do, and would like to be sure I have the right information! Thanks everyone. http://www.rxlist.com/cgi/generic3/diphenoxylate.htm and is as follows:Each diphenoxylate HCl and atropine sulfate tablet contains: Diphenoxylate Hydrochloride ...................... 2. 5 mg Atropine Sulfate ................... 0. 025 mg Diphenoxylate hydrochloride, an antidiarrheal, is ethyl 1-(3-cyano-3,3diphenylpropyl)-4-phenylisonipecotate monohydrochloride. Atropine sulfate an anticholinergic, is endo-(�)-a( hydroxymethyl) benzeneacetic acid 8-methyl-8-azabicyclo[3.2.1] oct-3-yl ester sulfate (2:1) (salt) monohydrate. Inactive ingredients include lactose (monohydrate), magnesium stearate, microcrystalline cellulose, and pregelatinized starch (corn). Diphenoxylate HCl and atropine sulfate is classified as a Schedule V controlled substance by federal law. Diphenoxylate hydrochloride is chemically related to the narcotic meperidine. Therefore, in case of overdosage, treatment is similar to that for meperidine or morphine intoxication, in which prolonged and careful monitoring is essential. Respiratory depression may be evidenced as late as 30 hours after ingestion and may recur in spite of an initial response to narcotic antagonists. A subtherapeutic amount of atropine sulfate is present to discourage deliberate overdosage.

 

[flux]

quote:two peristaltic movemnts - a short one and a longer wavelike one and one of them

There are two basic contractions in the intestine: propagating contractions (peristalsis) and mixing contractions (segmentation). I suppose you could have read someone trying to distinguish between ordinary peristalsis from giant migrating contractions (also called power propulsion). They are called high amplitude peristaltic contractions (HAPC). Are you even more confused now?

There are specific types of contractions as well such as short spike bursts and long spike bursts. They may not necessarily all be peristaltic in nature though.

quote:The definition for Lomotil tablets that said they are an antiperistaltic

It just seems the drug manufacturer and the PDR are using this term to mean one thing: inhibition of gut motility whereas physiologists use that term to mean something else, namely, gut motility toward the mouth. Because the two groups are using the term differently, that is why you are getting confused.

 

[sabriel]

Ok,So I think I understand

It is basically a case of perspective, like you say pot-ay-toh I say pot-ah-toh. Depending on the perspective of the reviewer whether or not Lomotil (and any of its constituent ingredients) are or are not antiperistaltic.Well, I guess as long as I know it stops my D and does not cause my legs to drop off or anything, I am pretty much satisfied.

I do understand the information about peristalsis too, kinda (I think). Ones body/GI tract/intestines have many kinds/types of contractions as food is digested, and different kinds of medication work on different areas.Thanks again, I hope I have not confused or baffled anyone else, I just like to try and understand the effects of the various meds I take.