Diarrhoea

Question 1

Symptom of diarrhoea

Answer 1

frequent watery stools, nausea, cramps , flatulence , dehydration

Question 2

dehydration causes/ symptoms and tx

Answer 2

tx dioralyte

dizzy light headed, dry mouth and lips, thirsty, dark yellow strong smell to urine, < 4times a day
notice if on diuretics, diabetic, too much alcohol, heatstroke, sweat exercise, high temp

Question 3

Warning and red flag

Answer 3

persistent diarrhoea , antibiotic colitis, children and elderly, systemic illness , recent hospital tx or travel ( except North America, Australia, NZ Western Europe), unexpected weight loss, rectal bleed

Question 4

name some antidiarrhoeal

Answer 4

Loperamide (opioid related)
kaolin with morphine
bulk forming laxative (treat constipation and diarrhoea
rifamixin (travel diarrhoea)

Question 5

1st line tx in diarrhoea

Answer 5

replenish lost volume depletion and electrolyte
ORT (oral rehydration therapy)
dioralyte (glucose , kcl , nacl )

Question 6

antibacterials in simple gastroenteritis?

Answer 6

not recommended as its self-limiting but people may use rifamixin in travellers diarrhoea as prophylaxis… again not recommend

Question 7

Loperamide MOA and dose and age

Answer 7

loperamide is a propulsive. its binds to opioid receptors in gut prolong gut transit so more water absorbed
age >12 yrs
dose - initially 4mg then 2mg for up to 5 days
Max dose (16mg = 8 tabs) a day

Question 8

MHRA warnings in case of abuse potential s/e loperamide

Answer 8

cardiac arrest, QT prolong, torsades des pointes

Question 9

overdose:

Answer 9

give nalaxone to reverse effects
repeated tx may be indicated
monitor patient for 48hrs due to CNS depressant effect

Question 10

common s/e of loperamide

Answer 10

dizzy nausea flatulence h/a

Question 11

C/I loperamide

Answer 11

Bloody diarrhoea fever ,severe, abdominal pain and inflammatory disease.
UC, Antibiotic colitis, condition where no peristalsis (gut motility), cond with abdominal distension