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Flashcards in Diarreha TBL Deck (49):
1

bismuth subsalicylate drugs

pepto, kaopeptate

2

MOA of bismuth subsalicylate

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

3

SE of bismuth subsalicylate

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

4

MOA of anti-diarrhea opiods

act on mu opiate receptors in the submucosal and myenteric plexus

5

anti-diarrhea opiods

loperamide (immodium), diphenoxylate + atropine

6

shortcomings of anti-diarreha opiods

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

7

prodrug
metabolized to active compound difenoxin

diphenoxylate

8

use of imodium

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

9

def of acute diarrhea

3+ loose, watery stools within 24 hours

10

def of chronic diarreha

Episodes of diarrhea lasting more than 14 days

11

def of dysentery

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

12

general cause of bloody diarreha

invasive pathenogen or cytotoxin releasing pathogens

13

bloody stool with no leukocytes indicates

EHEC

14

bugs that can cause bloody diarrhea

EHEC, Campylobacter, shigella, salmonalla, C diff

15

things to look for to asses dehydration

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

16

severe dehydration in kids

(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)

17

signs of dehydration in adults

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

18

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

ORS

19

main ingredients in ORS

electrolytes, sugar, water

20

type of ORS best for cholera

rice based ORS

21

used for rehydration in severe dehydration

lactated ringers, THEN ORS

22

what NOT to use for rehydration

5% dextrose and 1/4 normal saline

23

diarrhea less than 6 hrs after exposure could be

preformed toxins of Staph A or b cerus

24

diarrhea 6-12 hours after exposure could be

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