Diphenoxylate

Diphenoxylate is a synthetic **opioid agonist** used primarily as an **antidiarrheal** agent. It is typically formulated with a sub-therapeutic dose of **atropine** (as co-phenotrope) to discourage abuse. > **Warning:** Use with caution in infectious diarrhea or toxigenic infections, as decreasing GI motility can delay the clearance of pathogens and toxins. **Clinical Pearl:** While historically used for acute diarrhea, modern veterinary medicine often prefers addressing the underlying cause or using probiotics/prebiotics, reserving motility modifiers for specific refractory cases.

กลไกการออกฤทธิ์: Diphenoxylate acts locally and centrally on **mu-opioid receptors** in the gastrointestinal tract. * **Increases** intestinal segmental smooth muscle tone. * **Decreases** the propulsive activity (peristalsis) of smooth muscle. * **Decreases** electrolyte and water secretion into the intestinal lumen. → The addition of **atropine** is at a sub-therapeutic dose to cause unpleasant anticholinergic side effects if overdosed, thereby discouraging abuse.

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