LOPERAMIDE

PROVIDED BY :
MAZEN MAMDOUH
 Loperamide
Loperamide is a medicine to treat diarrhoea . Loperamide is also used for recurring or longer lasting
(runny poo). It can help with short-term diarrhoea from bowel conditions such as Crohn's
diarrhoea or irritable bowel syndrome (IBS). disease, ulcerative colitis and short bowel syndrome

Synonyms

loperamide 53179-11-6 Loperamida

Structure
Molecular Formula ActivityC29H33ClN2O2
Relationship
SAR for Opiates can be summarized as follows:
4-[4-(4-chlorophenyl)-4-
hydroxypiperidin-1-yl]-N,N-
dimethyl-2,2-diphenylbutanamide
IUPAC Name

1 Replacement of phenolic hydroxyl into –OCH3/-OC2H5 will make the drug less analgesic and cough suppression w
also takes place
2 Replacement of alcoholic hydroxyl with –OCH3 makes the compound 5 times more active.
3 Replacement of alcoholic hydroxyl with -OC2H5 makes the compound 2.4 times more active than morphine.
4 Replacement of alcoholic hydroxyl with –OCOCH3 will also activates the compound by 4.2 times.
5 Replacement of alcoholic hydroxyl with ketone group inactivates the compound and makes it lesser active.
6 By hydrogenation of alicyclic unsaturated linkage, activity increases by 1.2 times.
7 On replacement of the methyl group from tertiary nitrogen by hydrogen atom, activity decreases.
8 On replacement of N-CH3 by NCH2CH2Ph, activity increases by 14 times.
9 When the methyl group of tertiary nitrogen replaced by N-allyl/methallyl/propyl, the compound so formed acts l
the Morphine antagonist.
1 When the methyl group of tertiary nitrogen replaced by N(CH3)2 Cl– , compound have curare action and it do not
0 possesses any analgesic activity.

Uses
 This medication is used to treat sudden diarrhea (including traveler's diarrhea). It works
by slowing down the movement of the gut. This decreases the number of bowel
movements and makes the stool less watery. Loperamide is also used to reduce the
 amount of discharge in patients who have undergone an ileostomy. It is also used to treat
on-going diarrhea in people with inflammatory bowel disease.Loperamide treats only the
symptoms, not the cause of the diarrhea (such as infection). Treatment of other
symptoms and the cause of the diarrhea should be determined by your doctor.

MECHANISM OF ACTION
 Enteric neurons synthesize and release endogenous opioid peptides and other
neurotransmitters, such as acetylcholine and substance P. Endogenous opioids bind
to opioid receptors expressed on these neurons to regulate gastrointestinal
signalling, motility, and balance of fluids and electrolytes.

 Loperamide acts on the mu-opioid receptor expressed on the circular and

longitudinal intestinal muscle. Receptor binding leads to the recruitment of G-
protein receptor kinases and the activation of downstream molecular cascades that
inhibit enteric nerve activity. By inhibiting the excitability of enteric neurons,
loperamide suppresses neurotransmitter release, pre-synaptic and post-synaptic
inhibition of transmission of excitatory and inhibitory motor pathways, and
secretomotor pathways. Loperamide inhibits the release of acetylcholine and
prostaglandins, thereby reducing propulsive peristalsis and increasing intestinal
transit time. Loperamide stimulates the intestinal absorption of water and
electrolytes by inhibiting calmodulin. Loperamide can bind to and hyperpolarize
submucosal secretomotor neurons, promoting dry, hard stools.

loperamide trade name in egypt

IMODIUM
 STOPRRHEA

LOPRANST