2-33. DIPHENOXYLATE HYDROCHLORIDE AND ATROPINE SULFATE TABLETS
The trade name for diphenoxylate hydrochloride and atropine sulfate is Lomotil.
Diphenoxylate is a synthetic drug similar to the narcotic meperidine (Demerol), but
diphenoxylate is more highly constipating. Since diphenoxylate cannot be taken by the
parenteral route, and since it is mixed with atropine, it is not as likely to be abused as
other narcotics. There is no evidence of addiction liability in therapeutic doses. Lomotil
is used in the management of diarrhea due to gastroenteritis, functional hypermotility,
ulcerative colitis, drugs, and food poisoning. Each Lomotil tablet contains 2.5 mg of
diphenoxylate hydrochloride and 0.025 mg of atropine sulfate. The usual dose for initial
control is two tablets, 4 times daily. This may be decreased after control has been
Paregoric (camphorated opium tincture) contains 0.4 percent to 1 percent opium.
In the Army it is subject to the same controls as ethyl alcohol and "hard" narcotics (this
is indicated in the Federal Supply Catalog by a note R or Q). Opium induces spasm of
the colon, increases tone, and prevents propulsive movement. Therefore, paregoric is
used as an antidiarrheal agent and also as a weak agent for coughing, abdominal pains,
and nausea. The usual dose is 5-10 ml, one to four times daily.
Section VII. RESPIRATORY DRUGS
An antitussive is a drug used to suppress coughing. We are all familiar with the
traditional antitussive remedies, such as hard candies, cough drops, and lozenges. By
stimulating the flow of saliva, these agents help reduce the irritation which causes a
cough. In this paragraph, however, we will discuss only those antitussives that produce
a significant part of their effect after being absorbed into the body tissues (for example,
from the GI tract). Many of these act directly on the nerve connections in the medulla
which are responsible for the cough reflex.
a. Narcotics. The narcotic antitussives are very effective and have been in use
for some time. The fact that they are narcotics is not normally a decisive
contraindication for their use. However, they should not be used in the treatment of a
chronic (prolonged) cough or the cough of a client who tends to become psychologically
dependent on drugs. Among the cough remedies, it is possible to become addicted to
codeine (or its salts, such as codeine sulfate or codeine phosphate). This frequently
used antitussive will be discussed in a later section.