MEDICATIONS - Medicine for Mountaineering and Other Wilderness Activities - page 529

about engaging in activities for which drowsiness could be a hazard, particularly driving a
car.
MEDICATIONS FOR GASTROINTESTINAL DISORDERS
Paregoric
Paregoric (camphorated tincture of opium) is a mixture of several compounds, the most
important of which is morphine. This mixture is used to control diarrhea through the im-
mobilizing action of opium derivatives on the lower gastrointestinal tract.
Precautions: The problems related to using any drug to control diarrhea are discussed
in Chapter 19: Gastrointestinal Disorders .
Paregoric is classified as a controlled substance because it contains opium. Addiction to
paregoric does occur but is uncommon.
Diphenoxylate with Atropine
Diphenoxylate with atropine (Lomotil®) is a combination of two compounds used to
control diarrhea through slowing of intestinal mobility.
Precautions: Themostimportantcomplicationsresultingfromtheadministrationofdi-
phenoxylate are those from using any drug to control diarrhea.
Addiction is at least theoretically possible, and diphenoxylate is classified as a con-
trolled substance.
Loperamide
Loperamide (Imodium®) helps control diarrhea by reducing intestinal mobility. The
suspension and tablets are now available over the counter.
Precautions: The most important complications associated with the administration
of loperamide are those resulting from using any drug to control diarrhea ( Chapter 19:
Gastrointestinal Disorders ) .
Prochlorperazine and Promethazine
Prochlorperazine (Compazine®) was one of the first tranquilizers and is quite similar
to chlorpromazine (Thorazine), which is better known. Although these agents were major
therapeutic advances, more effective drugs have largely replaced them, and the principal
useofprochlorperazinecurrentlyistreatingseverenauseaandvomiting.Itisusefulathigh
altitudes because it is a mild respiratory stimulant.
Promethazine(Phenergan®)isachemicallycloselyrelateddrugthatalsohassignificant
antihistamine activity. However, a more common use is treating severe nausea and vomit-
ing.
Individuals who are vomiting repeatedly often are unable to retain oral medications and
rectal suppositories must be substituted.