Diarreha TBL Flashcards

(49 cards)

1
Q

bismuth subsalicylate drugs

A

pepto, kaopeptate

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2
Q

MOA of bismuth subsalicylate

A

inflammatory prostaglandins stimulate intestinal motility and diarrhea, inhibitors of cyclooxygenase
are antimotility; salicylate component completely absorbed; bismuth may stimulate absorption of
fluids and electrolytes across intestinal wall

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3
Q

SE of bismuth subsalicylate

A

constipating, high doses, like aspirin, may cause tinnitus; may cause temporary black tongue and
stools

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4
Q

MOA of anti-diarrhea opiods

A

act on mu opiate receptors in the submucosal and myenteric plexus

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5
Q

anti-diarrhea opiods

A

loperamide (immodium), diphenoxylate + atropine

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6
Q

shortcomings of anti-diarreha opiods

A

requires smaller dose of opioids to affect gut than to produce analgesia or euphoria, but physical
dependency still limits clinical use of some drugs; treats symptoms but not underlying cause

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7
Q

prodrug

metabolized to active compound difenoxin

A

diphenoxylate

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8
Q

use of imodium

A

acute non-specific diarrhea and chronic diarrhea associate with inflammatory bowel disease

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9
Q

def of acute diarrhea

A

3+ loose, watery stools within 24 hours

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10
Q

def of chronic diarreha

A

Episodes of diarrhea lasting more than 14 days

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11
Q

def of dysentery

A

Blood diarrhea, with visible blood and mucus present in the diarrhea

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12
Q

general cause of bloody diarreha

A

invasive pathenogen or cytotoxin releasing pathogens

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13
Q

bloody stool with no leukocytes indicates

A

EHEC

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14
Q

bugs that can cause bloody diarrhea

A

EHEC, Campylobacter, shigella, salmonalla, C diff

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15
Q

things to look for to asses dehydration

A

: general appearance, alertness, BP and pulse, postural hypotension, mucous membranes, sunken eyes, skin turgor, capillary refill, JVD, and sunken fontanelle

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16
Q

severe dehydration in kids

A

(2 or more) abnormally sleepy or lethargic (these are not the same thing!), sunken eyes, drinking poorly or not at all, very slow skin pinch test (>2 seconds)

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17
Q

signs of dehydration in adults

A
o	pulse rate >90
o	postural hypotension
o	supine hypotension and lack of palpable pulse
o	dry tongue
o	sunken eyeballs
o	slow skin pinch test
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18
Q

treatment of diarrhea that has lead to most of the drop in mortality

A

ORS

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19
Q

main ingredients in ORS

A

electrolytes, sugar, water

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20
Q

type of ORS best for cholera

A

rice based ORS

21
Q

used for rehydration in severe dehydration

A

lactated ringers, THEN ORS

22
Q

what NOT to use for rehydration

A

5% dextrose and 1/4 normal saline

23
Q

diarrhea less than 6 hrs after exposure could be

A

preformed toxins of Staph A or b cerus

24
Q

diarrhea 6-12 hours after exposure could be

A

preformed toxin of C perfringens or B cerus

25
bugs that are spread by food outbreak
salmonella, shiga toxin E coli, yersina, cyclospora
26
waterbourne transmission
crypto, giardia, vibro
27
seafood and shellfish transmission
vibro, norovirus, salmonella
28
poultry spread
campylobacer, salmonella
29
spread by beef, raw seed and sprouts
shiga e coli, ehec
30
spread from person to person
shigella, rotavirus
31
can be a result of antibiotic therapy
c diff
32
MOA of tetracyclines
: bind 30S binding site on ribosome to prevent binding of amino acid-charged tRNA
33
resistance to tetracyclines
: widespread; development of efflux pumps; formation of ribosomal protection protein that prevent tetracycline binding
34
MOA of macrolides
reversibly bind 50S ribosomal subunit near the MLSb site
35
resistance to macrolides
efflux pumps; methylase that adds methyl group to ribosomal binding site to block macrolide binding
36
MOA of sulfanamides
bacteriostatic inhibitors of folic acid synthesis by competitively inhibiting dihydropteroate synthase
37
resistance of sulfanamides
; plasma-mediated; decreased intracellular accumulation, increased PABA production by bacteria, or decreased sensitivity to the sulfonamide
38
MOA of trimethoprim
: selective inhibitor of bacterial DHFR inhibiting folic acid synthesis specifically in bacteria
39
resistance of trimethoprim
production of dihydrofolate reductase with reduced affinity for the drug
40
MOA of fluroquinlones
: inhibit topoisomerase II (DNA gyrase) especially in g(-) to block relaxation of supercoiled DNA and topoisomerase IV especially in g(+) to interfere with separation of replicated chromosomal DNA during cell division
41
resistance of fluroquinilones
decreased intracellular accumulation due to efflux pumps or porins (in g(-)); also changes in sensitivity via point mutations in antibiotic binding regions
42
DOC for protozoal infections
Metronidazole
43
SE of metronidazole
o contraindicated with alcohol – causes disulfiram-like reaction o also contraindicated in CNS disease and pregnancy because can get high concentrations in the CSF
44
community aquired/traveller's diarhhea probably
o contraindicated with alcohol – causes disulfiram-like reaction o also contraindicated in CNS disease and pregnancy because can get high concentrations in the CSF
45
HUS caused by
E coli (EHEC)
46
persistant diarrhea, think
EPEC or protozoa
47
bloody, mucoid diarrhea often with fever
EIEC
48
poultry and possible GB aftterwards
campylobacter
49
o There is an acute onset of nausea, vomiting, and diarrhea that may be watery or dysenteric, and fever
salmonella