Lomotil is a combination product containing diphenoxylate and atropine that is prescribed commonly for symptomatic treatment of diarrhea. Children are especially sensitive to small doses of Lomotil and may develop delayed toxicity after accidental ingestion. Motofen is a similar drug that contains difenoxin and atropine. Loperamide (Imodium) is a nonprescription drug with similar properties.

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   Mechanism of toxicity

   
   
   
   
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      Diphenoxylate is an opioid analog of meperidine. It is metabolized to difenoxin, which has fivefold the antidiarrheal activity of diphenoxylate. Both agents have opioid effects (See Opiates and Opioids) in overdose.

      
      
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      Atropine is an anticholinergic agent (See Anticholinergics) that may contribute to lethargy and coma. It also slows drug absorption and may delay the onset of symptoms.

      
      
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      Loperamide

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