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GI > Diarreha TBL > Flashcards

Diarreha TBL Flashcards

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
Q

bugs that are spread by food outbreak

A

salmonella, shiga toxin E coli, yersina, cyclospora

26
Q

waterbourne transmission

A

crypto, giardia, vibro

27
Q

seafood and shellfish transmission

A

vibro, norovirus, salmonella

28
Q

poultry spread

A

campylobacer, salmonella

29
Q

spread by beef, raw seed and sprouts

A

shiga e coli, ehec

30
Q

spread from person to person

A

shigella, rotavirus

31
Q

can be a result of antibiotic therapy

A

c diff

32
Q

MOA of tetracyclines

A

: bind 30S binding site on ribosome to prevent binding of amino acid-charged tRNA

33
Q

resistance to tetracyclines

A

: widespread; development of efflux pumps; formation of ribosomal protection protein that prevent tetracycline binding

34
Q

MOA of macrolides

A

reversibly bind 50S ribosomal subunit near the MLSb site

35
Q

resistance to macrolides

A

efflux pumps; methylase that adds methyl group to ribosomal binding site to block macrolide binding

36
Q

MOA of sulfanamides

A

bacteriostatic inhibitors of folic acid synthesis by competitively inhibiting dihydropteroate synthase

37
Q

resistance of sulfanamides

A

; plasma-mediated; decreased intracellular accumulation, increased PABA production by bacteria, or decreased sensitivity to the sulfonamide

38
Q

MOA of trimethoprim

A

: selective inhibitor of bacterial DHFR inhibiting folic acid synthesis specifically in bacteria

39
Q

resistance of trimethoprim

A

production of dihydrofolate reductase with reduced affinity for the drug

40
Q

MOA of fluroquinlones

A

: 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
Q

resistance of fluroquinilones

A

decreased intracellular accumulation due to efflux pumps or porins (in g(-)); also changes in sensitivity via point mutations in antibiotic binding regions

42
Q

DOC for protozoal infections

A

Metronidazole

43
Q

SE of metronidazole

A

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
Q

community aquired/traveller’s diarhhea probably

A

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
Q

HUS caused by

A

E coli (EHEC)

46
Q

persistant diarrhea, think

A

EPEC or protozoa

47
Q

bloody, mucoid diarrhea often with fever

A

EIEC

48
Q

poultry and possible GB aftterwards

A

campylobacter

49
Q

o There is an acute onset of nausea, vomiting, and diarrhea that may be watery or dysenteric, and fever

A

salmonella

GI (22 decks)

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