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A 14-year girl was admitted with akinesia and difficulty walking due to gait instability after two oral doses of compound diphenoxylate (lomotil). When she was 18-month old, drowsiness and inability to walk were observed after taking lomotil, the symptoms were relieved by taking B vitamins for treatment. The laboratory tests showed the increased blood branched chain amino acid levels; gene detection indicated that the child had compound heterozygous variations of c.745G>A(p.G249S) and c.485-1G>C in the BCKDHA gene. The girl was finally diagnosed as maple syrup urine disease. The domestic and foreign literature was searched, and 11 child cases of maple syrup urine disease with onset of unsteadiness and ataxia were reported, none of whom was associated with oral administration of compound diphenoxylate.
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Objective To investigate the prevalence of diphenoxylate abuse and related factors of forced drug abstainer in Gansu province.Methods By using a self-designed questionnaire,an epidemiologic investigation was carried out among 2 108 forced drug abstainer selected from the compulsory isolation detoxification center of Gansu province.A case-control study was conducted to analyze the factors related with diphenoxylate abuse.Results The diphenoxylate abuse rate among forced drug abstainer in Gansu was 19.8％ (406/2 046),ranking first in medical drug abuse.Multiple logistic regression analysis showed that factors as relieving withdrawal symptoms (OR=2.08,95％CI:1.01-4.32),ways to obtain diphenoxylate (other ways:OR=1.00;regular clinic:OR=27.67,95％CI:2.64-289.82;friend:OR=0.01,95％CI:0.01-0.03),degree of euphoria (high:OR=1.00;medium:OR=3.36,95％CI:1.18-9.55;low:OR=26.16,95％CI:10.30-66.42),years of drug abuse (＜5 years:OR=-1.00;10-15 years:OR=2.48,95％CI:1.02-6.04),abuse at home or in friend's house (OR=3.04,95％CI:1.08-8.68),abuse in car (OR=0.05,95％CI:0.00-0.68) and detoxification for the first time (OR=0.61,95％ CI:0.43-0.86) were the possible influencing factors for diphenoxylate abuse.Conclusions The prevalence of diphenoxylate abuse in forced drug abstainer in Gansu was relatively high.Reasons of abusing,the way to obtain diphenoxylate,whether using drug together with friends,degree of euphoria,years of abuse,abuse place and times for detoxification were related factors influencing the abuse of diphenoxylate.
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Objective To investigate the prevalence of diphenoxylate abuse and related factors of forced drug abstainer in Gansu province.Methods By using a self-designed questionnaire,an epidemiologic investigation was carried out among 2 108 forced drug abstainer selected from the compulsory isolation detoxification center of Gansu province.A case-control study was conducted to analyze the factors related with diphenoxylate abuse.Results The diphenoxylate abuse rate among forced drug abstainer in Gansu was 19.8％ (406/2 046),ranking first in medical drug abuse.Multiple logistic regression analysis showed that factors as relieving withdrawal symptoms (OR=2.08,95％CI:1.01-4.32),ways to obtain diphenoxylate (other ways:OR=1.00;regular clinic:OR=27.67,95％CI:2.64-289.82;friend:OR=0.01,95％CI:0.01-0.03),degree of euphoria (high:OR=1.00;medium:OR=3.36,95％CI:1.18-9.55;low:OR=26.16,95％CI:10.30-66.42),years of drug abuse (＜5 years:OR=-1.00;10-15 years:OR=2.48,95％CI:1.02-6.04),abuse at home or in friend's house (OR=3.04,95％CI:1.08-8.68),abuse in car (OR=0.05,95％CI:0.00-0.68) and detoxification for the first time (OR=0.61,95％ CI:0.43-0.86) were the possible influencing factors for diphenoxylate abuse.Conclusions The prevalence of diphenoxylate abuse in forced drug abstainer in Gansu was relatively high.Reasons of abusing,the way to obtain diphenoxylate,whether using drug together with friends,degree of euphoria,years of abuse,abuse place and times for detoxification were related factors influencing the abuse of diphenoxylate.
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Objective To explore the effect of compound orange peel bamboo shavings formula capsules on constipation by examining on chemical constipation mice.Methods Constipation was induced by oral administration of diphenoxylate and ondansetron.Mice were fed with compound orange peel bamboo shavings formula capsule at the doses of 3.2, 1.6 and 0.8 g/kg, respectively.Results The middle dose and high dose of compound orange peel bamboo shavings formula capsule shortened the start time of defecation, and increased fecal pellets number and wet weight in the diphenoxylate-induced constipated mice or the ondansetron-induced constipated mice (P ＜ 0.05).Conclusion Compound orange peel bamboo shavings formula capsule produces a laxative activity against diphenoxylate-induced constipated mice or ondansetroninduced constipated mice.
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Objective To observe the antidiarrheal and analgesic effects of Dingguier paste on the mouse. Methods Tho diarrhea mouse models were made by senna leaf or castor oil to detect the antidiarrheal effect of Dingguier paste combination with other drugs. The hot plate test and acetic acid test were used to observe the analgesic effect of Dingguier oral medicine and Dingguier paste in combined use with other drugs. Results Compared with senna leaf model group, Dingguier paste low-dose, middle-dose, high-dose combined with diphenoxylate, Bupi-Yichang pill and Dingguier oral medicine group could decrease the number of feces in 2 h [Number of each group feces was(0.50±1.27), (2.27±2.90), (1.18±1.83);(2.00±2.26), (3.40±2.17), (3.82±1.72);(0.73±1.56), (1.91±2.95), (2.55±2.11)]. Dingguier paste low-dose and high-dose combined with diphenoxylate could decrease the number of feces in 4h [Number of each group feces was (6.70±2.11), (6.27±3.20)]. Dingguier oral group decrease the number of feces in 6h [Number of feces was (6.91±2.77)]. Compared with castor oil model group, Dingguier paste low-dose combined with diphenoxylate could obviously decrease the number of feces in 2 h, 4 h and 6 h [Number of each group feces was(0.45±0.82), (0.45±0.82), (4.27±2.15)]. Dingguier paste middle-dose combined with diphenoxylate could decrease the number of feces in 6 h [Number of feces was (4.64±2.45)]. Dingguier oral group decrease the number of feces in 2 h, 4 h, 6 h [Number of each group feces was (0.45±0.82), (2.91±2.07), (4.27±2.15)].Compared with normal group, the threshold of pain stimulated by hot plate of the Dingguier paste each dose combined with rotundin could increased remarkable after 30 min, 60 min, 90 min and 120 min[The time of Dingguier paste low-dose was(52.32 ± 17.29)s, (56.24 ± 12.48)s, (57.28 ± 6.61)s, (58.58 ± 4.70)s; the time of Dingguier paste middle-dose was (48.27±19.35)s, (54.92±12.59)s, (55.91±11.48)s, (55.15±12.49)s;the time of Dingguier paste high-dose was (49.15±15.69)s, (56.24±11.89)s, 60 s is(59.08±2.93)s]. Compared with normal group, the eclipse time of pain irritated by acetic acid of the Dingguier paste middle-dose combined with indomethacin could increased remarkable(14.72±5.99)min, the writhing frequency could decrease of the Dingguier paste each dose combined with indomethacin[Number of each dose writhing frequency was (7.62±8.31), (3.62± 6.14), (11.25±9.46)]. Conclusion Dingguier paste in the combination use with other drugs and Dingguier oral medicine may have some antidiarrheal and analgesia effects.
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Objective To investigate ulinastatin combined with diphenoxylate efficacy patients with severe acute pancreatitis.Methods 90 cases with severe acute pancreatitis patients hospital as the object of study,were randomly divided into experimental group and control group,ulinastatin replication treatment control group,the experimental group were treated with ulinastatin joint diphenoxylate adjuvant treatment,and before and after the medical treatment of TNF-α,IL-6,IL-18 the detection,and the treatment efficacy of the patient's evaluation.Results The patients abdominal pain time,signs alleviate time,the white blood cell count recovery time to resume normal serum amylase time,the urine amylase recovery time,average length of stay (4.3 ± 1.4)d vs (6.4 ± 2.3)d,(4.1 ± 1.5)d vs (6.5 ±1.4)d,(7.3 ±3.5)d vs (10.3 ±2.3)d,(4.5 ±l.5)d vs (7.9 ±2.3)d,(5.4±l.2)d vs (8.2 ±2.3)d,(22.3 ±3.7)d vs (31.5 ±3.4)d(t =5.2319,7.846,5,4.8052,8.3061,7.2403,12.2818,all P ＜0.05),the two groups of patients receiving treatment,3d,7d,and 14d of TNF-α,IL-6,IL-18,the levels of endotoxin has statistical difference (P ＜ 0.05) (t =6.3843,8.9328,5.938,4.9381,all P ＜ 0.05),the experimental group patients with an effective rate of 97.78％,88.89％ was significantly better than the control group(x2 =12.932,P ＜ 0.05).Concltusion Ulinastatin combined with diphenoxylate has good clinical efficacy in acute severe pancreatitis,which is worthy of promotion in the clinical.
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Naphazoline,Diphenoxylate, Over-the-counter (OTC) cough and cold medications, widely used for the symptomatic relief of nasal obstruction, diarrhea or common cold symptoms. But these medicines might cause poisoning even if utilized in recommended doses for treatment. The side effects of these medicines were neglected when they were used much more commonly. The clinical manifestation of these medicine poisoning were delitescence and children' s parents couldn't provide the whole history, so these medicine poisoning were often misdiagnosis, even lead to treatment failure. We explore the toxicities of these medicines ,discuss their mechanisms and clinical manifestation, and suggest why physicians should be more vigilant in specifically inquiring about them when evaluating an ill child.
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Objective To observe the clinical efficacy of small-dose ranitidine hydrochloride and diphenoxy- late compositae in the combined treatment of diarrhea-predominant irritable bowel syndrome(D-IBS).Methods A prospective,randomized controlled clinical trial was designed.150 D-IBS patients according to RomeⅡcriteria were randomly divided into combined treatment group and control group.The combined treatment group(74 patients)re- ceived ranitidine hydrochloride,0.15g,each evening and diphenoxylate compositae,1 piece,each evening.The control group(76 patients)received diphenoxylate compositae,1 piece,rid.This study consisted of a 2-week baseline period, a 3-week treatment period,followed by a 2-week follow-up period.The main efficacy variable was assessed by per- ception of overall symptom during the previous weeks.Secondary efficacy variables included severity of diarrhea,ab- dominal pain and distention and other symptoms.Results After treatment of 3 weeks,the efficacy of the combined treatment group was better than that of the control group(x~2=5.10,P