Tolevamer - Averts The Squirts

Tolevamer is a high molecular mass polyanion (i.e. a bunch of highly charged goop) that is used to treat the particularly profuse diarrhea (when you're sittin' in your Chevy / and you feel something heavy!) associated with an infection caused by the bacterium Clostridium difficile. As it's name implies, C. difficile (or C. diff, as the kids call it these days) is a pain in the ass (heh) to treat, since it generally shows up and takes over your intestines when you are already on antibiotics (which kill the normal intestinal bacterial flora that helps protect your gut from infection).

Tolevamer strongly binding to and inhibits the action of C. difficile toxins A and B, which otherwise act on the walls of the intestine in such a manner as to cause inflammation and tissue damage, resulting in your favourite and mine, liquid stool [1]. In extreme cases, these toxins can cause pseudomembranous colitis and toxic megacolon, the latter of which is pretty much the worst thing ever. Notably, tolevamer is not an antibiotic, since it doesn't directly affect C. difficile, making it a novel means of treating infection: neutralize the toxin that is responsible for the pathogenicity instead of trying the kill the bug!

[1] Braunlin W, Xu Q, Hook P, Fitzpatrick R, Klinger JD, Burrier R, Kurtz CB. (2004). Toxin binding of tolevamer, a polyanionic drug that protects against antibiotic-associated diarrhea. Biophys J 87: 534-539.

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