antidiarheals Flashcards
diarrhea is defined as?
Passage of three or more loose or liquid stools per day// stool that contains fluid weight over 200g of fluid per day.
contraindications of antidiarrheals
severe illness, bloody diarrhea, or high fever because they can mask or exacerbate the underlying condition.
types of diarrhea acc to etiology
osmotic, secretory, inflammatory
reason for osmotic diarrhea
poor absorption of certain molecules, which leads to an excessive amount of solutes in the intestinal lumen. so water is pulled along with it
1 condition causing osmotic diarrhea
lactose intolerance, where there’s a deficiency in the brush border enzyme lactase in the small intestine, which breaks down lactose.
The excess lactose stays in the lumen and pulls water into the intestinal lumen, leading to diarrhea.
secretory diarrhea reason?
there’s increased secretion or decreased absorption of ions like chloride or bicarbonate.
secretory diarrhea causative agents
bacterial endotoxins, like cholera toxin released by vibrio cholerae.
This toxin increases the secretion of chloride and bicarbonate ions in the small intestine, while inhibiting Sodium ion absorption.
These ions build up and cause an osmotic effect, sucking more water into the lumen from the surrounding tissues.
What differentiates it from osmotic diarrhea is that symptoms remain, even with decreased oral intake.
inflammatory diarrhea?
immune mediated damage to the epithelial lining of the large and small intestine, which impairs their absorptive ability for nutrients and water.
causes of inflammatory diarrhea
inflammatory bowel diseases like Crohn disease and ulcerative colitis, or infections, most commonly by viruses like rotavirus, and bacteria like salmonella, shigella, or E.coli.
why is there diarrhea in ibs
increased enteric nervous system activation, which leads to increased frequency of peristalsis—-less time for water and nutrients to be reabsorbed
when should antidiarrheals be given?
risks of developing conditions like dehydration, hypotension, hypokalemia, and metabolic acidosis.
primary treatment for diarrhea
Most cases of diarrhea are self limiting and no treatment is necessary.. replace the fluids and electrolytes
types of diarrhea acc to content/time
Acute watery diarrhea – lasts several hours or days, and includes cholera.
Acute bloody diarrhea – also called Dysentery
Persistent diarrhea – lasts 14 days or longer.
moa of opioid agonist
stimulating the mu (μ) or delta (δ) opioid receptors found in the neurons of the enteric nervous system and smooth muscle, which decreases peristalsis.
lead to increased colonic transit time and fecal water absorption.
They also decrease mass colonic movements and the gastrocolic reflex.
