Diarr/IBS/Const Flashcards
1
Q
What is lubiprostone used for?
A
IBS-C more so. helps with opioid induced constipation
2
Q
When does food poisoning usually start?
A
May start within hours, or begin days or weeks after, Has a broad range of effect
3
Q
What is the only thing recommended for child VGE?
A
Fluids
4
Q
What is critical for children treatment of TD?
A
Fluids
Imodium is MD only
5
Q
How much PEG 3350 should a child be given?
A
1/2 capful, but its not for kids unless MD
6
Q
What are the symptoms of IBS?
A
Pain/Spasms
Bloating
urgency
Constipation and diarrhea
Mucous in stool
> 6 months
7
Q
For mild cases of Drug-induced diarrhea what can we use?
A
Imodium and Culturelle (Only if AB)
8
Q
What is important with taking psylium
A
Take it with atleast a cup of water and
if you have diabetes watch for the flavoured agent
9
Q
What is psyllium recommended for?
A
IBS-C
10
Q
What are the stimulants Senokat dosing?
A
Extra strength= 1-2 tabs OD BID at night
Normal Strength = 2-4 tabs OD-BID at night
11
Q
How much senna does one usually start with?
A
8mg then titrate up
12
Q
Why is mineral oil not really indicated for constipation?
A
Can cause anal seepage
13
Q
What is the treatment strategies for TD that has occured?
A
RX Ab usage if it reaches moderate
Loperamide alone
Pepto
14
Q
How long does Phillips take to work?
A
Overnight
Saline constipation
15
Q
What is docusate/Colace?
A
not entirely effective agent that takes 1-2 days to work
16
Q
What are prevention strategies for travellers diarrhea?
A
RX antibiotics (onset)
Peptobismol
Dukoral vaccine
17
Q
What is the Pepto dosing for prophylaxis?
A
2 tabs QID for 3 weeks max
18
Q
What other things should be kept in mind when thinking of constipation?
A
Medication
Diabetes
Colon cancer
IBS
Depression
19
Q
Most fermentable fibers are?
A
soluble
20
Q
What should we watch for in pediatric diarrhea?
A
Watch for dehydration
21
Q
Should we increase water in constipation?
A
no we get lots of water in food
22
Q
What are common causes of child constipation?
A
Too busy to poop
Dietary issues
Toilet training issues
23
Q
Common cause of diarrhea in pediatrics?
A
Viral gastroenteritis
24
Q
What does loperamide do?
A
decrease diarrhea not much jelp with pain though
25
When does psylium become effective?
12-72 hours post taking it
26
How fast does Fleet work? (Enema)
2-5 minutes
27
How often does a formula fed babies have a BM?
2 a day
28
For cases of kids Diarrhea what can we use?
Imodium is off label, but Culturelle is only an option for AB-induced
29
What will fiber do?
Helps with BM habits
30
What is lubiprostone capsules used for?
IBS-C
Also Opioid medications
31
How can we prevent constipation in elderly?
Bulk forming agents, docusate, peg 3350
32
What are the TCAs that may help?
amitriptyline or desipramine at low doses
33
When should someone get help for constipation in terms of time?
Constipation lingers for 3 weeks or changes in bowel habit of more than 2 weeks
34
How can we stimulate paediatric BM?
MD
Rectal stimulation with Qtip and vaseline
Glycerin suppository
35
What is inulin/Prebiotic
It is a non thickening agent that can be added to food or fluid, similar to psylium
36
How long does mineral oil take to work?
6-8 hours, taken very enema works very quick though
37
What is Bismuth subsalicylate (BSS)
Not routinely recommended as they have different side effects
38
What if TD AB did not work?
Switch to pepto 1/2 QH dosing or loperamide
39
What is the onset of senna combo with docusate
Senna 6-8 hours, Docusate = 3 days
40
What are side effects of bisacodyl and senna?
minimally absorbed, but can lead to diarrhea, Stimulants
41
What does Saline do?
Draws water into the gut
42
What is the causes of constipation?
Disease states
Drug causes
Immobility
Fluids
43
What is very common treatment for pregnancy?
Docusate
Peg 3350
Psyllium
44
Is breastmilk a clear fluid?
yes
45
What is constella?
Moderate to severe treatment of IBS-C
46
What does the symptomatic treatment of diarrhea consist of?
Rehydration and proper diet
47
How does psylium induced obstruction occur?
by not taking the product with enough water
48
What does polycarbophil do?
It is a preventative agent for constipation that works in 12-72 hours
49
What food is a bulk-forming agent non food?
Soluble fibre
50
What is a key factor to consider with constipation
Is when someone has a significant decrease in frequency of bowel movements
51
What is the dosing of Peg 3350?
Capful (17g) then titrate every 2-3 days until mushy stool consistency
52
What do sufferers of IBS tend to over-react with?
Fructose, gluten
53
How do you take Senna when on T-3?
T3 late in day 8mg first night
T3 in AM 16mg first night
54
What if TD and Pepto was not working?
Switch to antibiotic and loperamide
55
What are red flags of constipation?
Stool texture change, blood, hemorhoids, weight loss, pain, narrower stools
56
What is the normal BM activity?
wide range 2x per week to 3x per day
57
What is the most common virus of gastroenteritis in children?
Rotaviruses
58
What is psyllium used for?
IBS-C
59
If dehydration is of concern what should we recommend?
Gastrolyte or pedialute
60
Onset of senokat?
6-12 hours
61
What does pepto help with?
Disagreeable foods
62
What is the most common symptom of IBS?
Abdominal pain, less severe after a bowel movement
63
What does a bowel obstruction usually lead to?
Constipation with very dramatic progression in symptoms
64
What is psyllium?
Metamucil
65
What is loperamide used for?
IBS-d
66
What are Bentylol and Buscopan
Not first line agents of IBS, due to higher S/E profile
67
What are the smooth muscle relaxants
Pinaverium
Trimebutine
68
How common is a food allergy?
Less then 10% incidence decreases with age due to protein
69
How long does lactulose syrup take to take effect?
1-2 days
70
When do we refer for diarrhea?
<6 months
1/2 to 1 year = 1 day
1 to 3 2 days
>3 3 days
*Quicker if other symptoms like fever, blood or vomiting is occurent
71
Which AB is good for the treatment of Travelers Diarrhea?
Rifaximin
72
What is Culturelle Probiotics?
May help with AB associated diarrhea, but it has not ben shown/proven
73
How is the Rotavirus vaccine given?
By mouth not by needle
74
What in pinaverium
CC antagonists in the smooth intestine, used for both C/D
75
What dose of magnesium is required for a laxative effect?
~250mg
76
What is a normal BM for infants
1bm per each feed to 1 per week
77
What often co-exists with IBS?
Anxiety or depression
78
Is constipation a normal part of aging?
NO!
79
What is the youngest age that we can recommend an enema?
2 yo
80
What is not necessarily first line for pregnancy due to CI
MOM, Senna, Bisacodyl
81
What is trimebutine?
Opiate receptor agonist 5HT3 antagonist
82
What is Ibrela used for?
IBS-C
83
What is the dose of psyllium (Metamucil)?
2-4 tablespoons daily with fluids
84
What is the main decision made with antibiotic useage with TD?
Add loperamide to counteract the S/E of Diarrhea
85
What is Kaopectate?
anti-diarrheal agents, safe but likely ineffective
86
What is Stool softener?
added to other laxatives and preventative measures
87
What is peppermint Oil for?
Broadly used for both IBS-C and IBS-D
88
What is loperamide?
Imodium
89
What is the pepto dosing for treatment?
2 tabs Q 1/2 hours up to 8 doses
90
Is pepto-bismol used for drug-induced diarrhea?
No, since it is not indicated
91
What is Senna?
It provides relief of acute constipation with 6-12 hours
92
What are the BMs of IBS-C on bristol stool chart
1-2
93
What are the smooth muscle relaxants used for?
IBS-D or IBS-C
94
How long does stimulants take to work?
6-12 hours
95
What is the dosage of Dulcolax?
Suppository, Once a day
Oral = 1-2 tabs daily
96
Why should loperamide be avoided in severe diarrhea?
Since our body might be wanting to empty pathogens
97
What are glycerin suppositories especially good in?
infants and young children because it causes a bowel evac within 30 minutes
98
What are dietary ways of managing IBS?
Fiber
Reducing fatty foods
Avoid offending foods
99
What type of fibre should we add?
Soluble and insoluble fibre slowly
5g a day
100
Does miralax help with IBS-C?
It improves symptoms of constipation, but it does nothing to help with the spasms associated with IBS
101
What is the common side effects of lactulose syrup?
gas/bloating
102
What can food allergies cause?
Rash GI symptoms, anaphylaxis
103
Common causes of pediatrics constipation
Starting solid food
Low fluids
104
What is a key component of constipation?
Straining
105
What are the BMs of IBS-D on bristol stool chart?
6-7
106
What is eluxadoline used for?
IBS-D Expensive though
107
What are Antidepressants (TCAs) used for?
IBS-D and pain
108
What is the three types IBS?
IBSC
IBSD
IBS Mixed
109
What is Ovol?
This is an anti-flatulent agent, will not work for IBS
110
What are osmotic laxatives use carefully in?
Those with chonic renal or congestive heart failure
111
What are stimulants?
Phenolphthalein (ExLax)
112
How many BM do breastfed babies have?
once every 7-10 days
113
What does peppermint oil do?
Can help with spasms, bloating, gas
114
Should Pepto be used in kids?
no
115
What usually causes diarrhea from food?
Usually something in the food is an irritant or natural laxative
116
What is PEG 3350?
Miralax or Restoralax
117
What is the MOA of stimulants?
irritant to gut linings
118
What is the rate of microlax enemas
5ml dose evacuation in 5-20 minutes
Used in nursing home commonly
119
What is Peg 3350 used?
Preventative therapy.
120
How often do people with IBS avoid certain foods?
all the time
121
What is Colyte
Pre-colonoscopy
drink 240ml every 10 minutes to 4L
BM in 1 hour
122
What age is Imodium CI in?
<2, but under 12 is not recommended
123
What is the dosing of loperamide?
2-4mg up to QID
124
What is rifaximin used for?
IBS-D
125
What can SSRI be used?
IBS-C and depression, may help reduce pain
126
Onset of dulcolax (Docusate)
Supp = 15-60 minutes
Oral= 6-12 hours
127
What is immodium not good for?
Prophylaxis treatment of TD
128
Where is sorbitol located?
In prunes/plums and it has an instant laxative effect
129
What are the three options of Drug-Induced diarrhea?
Withdrawal
Continue
Adjust dose
130
What is IBgard?
Concentrated peppermint oil
131
What could be switched temporarily to help reduce infant diarrhea?
Lactose free infant formula
132
What can high doses of imodium do?
Withdrawal symptoms of opiates, but ventricular arrhythmias can occur
