The medication, Lomotil, combines two drugs, namely, atropine and diphenoxylate. The artificial narcotic, employed in the treatment of acute limited-duration diarrhea, is associated, chemically, with Demerol or meperidine. Akin to other narcotic drugs, diphenoxylate decreases diarrhea owing to its hindrance of intestinal contents' forward motion across the intestines. This drug has been linked, chemically, to narcotics, but, unlike a majority of other narcotic drugs, it lacks analgesic or pain-relieving action. Nevertheless, higher doses of diphenoxylate may lead to physical dependency and elation akin to other narcotic drugs. For preventing diphenoxylate abuse for generating feelings of exultation, the drug, atropine, is used in small amounts in combination with it. Consequently, consuming a higher dosage of Lomotil than recommended results in adverse effects from excess atropine consumption. Besides Lomotil, the other brand names for atropine and diphenoxylate are Lonox and Lofene (Ogbru, 2019).
Some of diphenoxylate's most widely-occurring adverse effects among patients are: sleepiness, vomiting, headache, dry mouth, and queasiness (Ogbru, 2019). A few medications which can potentially interact with diphenoxylate are: naltrexone, pramlintide, potassium capsules/tablets, and MAO (monoamine oxidase) inhibitors (like linezolid, isocarboxazid, methylene blue, phenelzine, moclobemide, rasagiline, procarbazine, selegiline, tranylcypromine, and safinamide) (WedMD, 2019). CDAD (clostridium difficile–associated diarrhea) is being increasingly acknowledged as the source of nosocomial ailments. Narcotic analgesics, loperamide (Imodium), atropine-diphenoxylate combinations (Lomotil) and other anti-peristaltic agents ought to be avoided as they can impede toxin clearance from the patient's colon, thus precipitating toxic and ileus dilatation and exacerbating colon injury due to toxins (Agzew, 2005).
Wiwanitkit and Joob's 2014 research reveals that Lomotil is extensively bought and readily available; patients in certain settings commonly keep this simple medication at home to treat diarrhea. However, it must be borne in mind that frequently consuming the medication may lead to dependency, thereby rendering gastrointestinal disorder management challenging.
References
Agzew, Y. (2005). Clostridium difficile–Associated Diarrhea and Colitis: A Significant Cause of Nosocomial Infection. Retrieved from https://www.the-hospitalist.org/hospitalist/article/122898/clostridium-difficile-associated-diarrhea-and-colitis-significant-cause
Joob, B., & Wiwanitkit, V. (2014). Lomotil dependence. Indian J Psychol Med, 36(3), 348-349. Doi: 10.4103/0253-7176.135401
Ogbru, O. (2019). Diphenoxylate and atropine (Lomotil). Retrieved from https://www.medicinenet.com/diphenoxylate_and_atropine/article.htm#what_is_diphenoxylate_and_atropine_and_how_does_it_work_mechanism_of_action
WebMD. (2019). Lomotil. Retrieved from https://www.webmd.com/drugs/2/drug-6876/lomotil-oral/details