Farmacoriflessioni
Il racecadotril
DRUG THERAPY OF ACUTE DIARRHEA: RACECADOTRIL
MASSIMO FONTANA
Struttura Complessa di Pediatria, Ospedale dei Bambini “V. Buzzi”, Milano
Gennaio 2008 - pagg. 43 -46
Abstract
Racecadotril, through the competitive inhibition of enkephalinase, increases the activity of endogenous
enkephalines and reduces the intestinal secretion in vitro and in animal models. Clinical
trials showed its efficacy in acute diarrhea of adults and children. The most relevant finding
is its ability to rapidly reduce the stool output. In this paper are briefly discussed the clinical
indications and the safety profile of the drug.
Classificazione MeSH
Bibliografia
1. WHO. The treatment of diarrhoea. A manual
for physicians and other senior health workers.
http://www.who.int/child-adolescenthealth/
New_Publications/CHILD_HEALTH/I
SBN_92_4_159318_0.pdf
2. Pol O, Palacio JR, Puig MM. The expression of d- and k-opioid receptor is enhanced during intestinal inflammation in mice. J Pharmacol Exp Ther 2003;306:455-62.
3. Farthing MJG. Enkephalinase inhibition:a rational approach to antisecretory therapy for acute diarrhoea. Aliment Pharmacol Ther 1999;13 Suppl 6:1-2.
4. Boshuizen JA, Reimerink JH, Korteland-van Male AM, et al. Changes in small intestinal homeostasis, morphology, and gene expression during rotavirus infection of infant mice. J Virol 2003;77:13005-16.
5. Sandhu B, Isolauri E, Walker-Smith JA, et al. Early feeding in childhood gastroenteritis. JPGN 1997;24:522-7.
6. Brown KH, Peerson JM, Fontaine O. Use of nonhuman milks in the dietary management of young children with acute diarrhea: a metaanalysis of clinical trials. Pediatrics 1994;93:17- 27.
7. Molla AM, Rahman M, Sarker SA, Sack DA, Molla A. Stool electrolyte content and purging rates in diarrhea caused by Rotavirus, enterotoxigenic E. coli, and V. cholerae in children. J Pediatr 1984;98:835-8.
8. Ramig RF. Pathogenesis of intestinal and systemic Rotavirus infection. J Virol 2004;78: 10213-20.
9. Borghan MA, Mori Y, El-Mahmoudy AB, et al. Induction of nitric oxide synthase by Rotavirus enterotoxin NSP4: implication for Rotavirus pathogenicity. J Gen Virol 2007;88:2064-72.
10. Centers for Disease Control and Prevention. Managing acute gastroenteritis among children. MMWR 2003;52:1-16.
11. Salazar-Lindo E, Santisteban-Ponce J, Chea- Woo E, Gutierrez M. Racecadotril in the treatment of acute watery diarrhea in children. N Engl J Med 2000;343:463-7.
12. Cezard JP, Duhamel JF, Meyer M, et al. Efficacy and tolerability of racecadotril in acute diarrhea in children. Gastroenterology 2001; 120:799-805.
13. Murtaza A, Zulfiqar I, Khan SR, Lindblad BS, Aperia A. Regulation of serum sodium in dehydrated and orally rehydrated infants. Influence of age and of purging rates. Acta Paediatr Scand 1987;76:424-30.
14. Cojocaru B, Bocquet N, Timsit S, et al. Effet du racecadotril sur le recours aux soins dans le traitment des diarrhees aigues du nourisson et de l’enfant. Arch Pediatr 2002 ;8:774-9.
15. Turck D, Berard H, Fretault N, Lecomte JM. Comparison of racecadotril and loperamide in children with acute diarrhoea. Aliment Pharmacol Ther 1999;13 (Suppl 6):27-32.
16. Duval-Iflah Y, Berard H, Baumer P, et al. Effects of racecadotril and loperamide on bacterial proliferation and on the central nervous system of the newborn gnotobiotic piglet. Aliment Pharmacol Ther 1999;13 (Suppl 6):9-14.
17. Fontana M, Federico P, Santucci S. Il ricovero pediatrico in Lombardia: cause, variabilità e possibile inappropriatezza. Medico e Bambino 2007;26(8):520-6.
18. Fontana M, Zuin G, Pancheri P, Fusco FC, Lambertini A, Berni Canani R, and SIGEP Working Group on Intestinal Infections. Costs associated with outpatient diarrhoea in infants and toddlers: a nationwide study of the Italian Society of Paediatric Gastroenterology and Hepatology (SIGEP). Dig Liv Dis 2004;36:523-7.
19. Bhattacharya SK, Bhattacharya MK, Manna B, et al. Risk factors for development of dehydration in young children with acute watery diarrhoea: a case-control study. Acta Paediatr 1995;84:160-4.
20. Kilgore P, Holman RC, Clarke MJ, Glass RI. Trends od diarrheal disease-associated mortality in US children, 1968 through 1991. JAMA 1995;274:1143-8.
2. Pol O, Palacio JR, Puig MM. The expression of d- and k-opioid receptor is enhanced during intestinal inflammation in mice. J Pharmacol Exp Ther 2003;306:455-62.
3. Farthing MJG. Enkephalinase inhibition:a rational approach to antisecretory therapy for acute diarrhoea. Aliment Pharmacol Ther 1999;13 Suppl 6:1-2.
4. Boshuizen JA, Reimerink JH, Korteland-van Male AM, et al. Changes in small intestinal homeostasis, morphology, and gene expression during rotavirus infection of infant mice. J Virol 2003;77:13005-16.
5. Sandhu B, Isolauri E, Walker-Smith JA, et al. Early feeding in childhood gastroenteritis. JPGN 1997;24:522-7.
6. Brown KH, Peerson JM, Fontaine O. Use of nonhuman milks in the dietary management of young children with acute diarrhea: a metaanalysis of clinical trials. Pediatrics 1994;93:17- 27.
7. Molla AM, Rahman M, Sarker SA, Sack DA, Molla A. Stool electrolyte content and purging rates in diarrhea caused by Rotavirus, enterotoxigenic E. coli, and V. cholerae in children. J Pediatr 1984;98:835-8.
8. Ramig RF. Pathogenesis of intestinal and systemic Rotavirus infection. J Virol 2004;78: 10213-20.
9. Borghan MA, Mori Y, El-Mahmoudy AB, et al. Induction of nitric oxide synthase by Rotavirus enterotoxin NSP4: implication for Rotavirus pathogenicity. J Gen Virol 2007;88:2064-72.
10. Centers for Disease Control and Prevention. Managing acute gastroenteritis among children. MMWR 2003;52:1-16.
11. Salazar-Lindo E, Santisteban-Ponce J, Chea- Woo E, Gutierrez M. Racecadotril in the treatment of acute watery diarrhea in children. N Engl J Med 2000;343:463-7.
12. Cezard JP, Duhamel JF, Meyer M, et al. Efficacy and tolerability of racecadotril in acute diarrhea in children. Gastroenterology 2001; 120:799-805.
13. Murtaza A, Zulfiqar I, Khan SR, Lindblad BS, Aperia A. Regulation of serum sodium in dehydrated and orally rehydrated infants. Influence of age and of purging rates. Acta Paediatr Scand 1987;76:424-30.
14. Cojocaru B, Bocquet N, Timsit S, et al. Effet du racecadotril sur le recours aux soins dans le traitment des diarrhees aigues du nourisson et de l’enfant. Arch Pediatr 2002 ;8:774-9.
15. Turck D, Berard H, Fretault N, Lecomte JM. Comparison of racecadotril and loperamide in children with acute diarrhoea. Aliment Pharmacol Ther 1999;13 (Suppl 6):27-32.
16. Duval-Iflah Y, Berard H, Baumer P, et al. Effects of racecadotril and loperamide on bacterial proliferation and on the central nervous system of the newborn gnotobiotic piglet. Aliment Pharmacol Ther 1999;13 (Suppl 6):9-14.
17. Fontana M, Federico P, Santucci S. Il ricovero pediatrico in Lombardia: cause, variabilità e possibile inappropriatezza. Medico e Bambino 2007;26(8):520-6.
18. Fontana M, Zuin G, Pancheri P, Fusco FC, Lambertini A, Berni Canani R, and SIGEP Working Group on Intestinal Infections. Costs associated with outpatient diarrhoea in infants and toddlers: a nationwide study of the Italian Society of Paediatric Gastroenterology and Hepatology (SIGEP). Dig Liv Dis 2004;36:523-7.
19. Bhattacharya SK, Bhattacharya MK, Manna B, et al. Risk factors for development of dehydration in young children with acute watery diarrhoea: a case-control study. Acta Paediatr 1995;84:160-4.
20. Kilgore P, Holman RC, Clarke MJ, Glass RI. Trends od diarrheal disease-associated mortality in US children, 1968 through 1991. JAMA 1995;274:1143-8.
Corrispondenza: fontana@unimi.it