Diarrhea

Question 1

Etiologies of diarrhea

Answer 1

Gastroenteritis (from viral or bacterial pathogens), contaminated water
Food intolerance
Celiac disease
IBS, IBD
Medications (ABX and chemotherapy)

Question 2

What do you have to watch out for if a patient has diarrhea while taking ABX?

Answer 2

Make sure it’s not a C. diff infection!

Question 3

Opiate derivative medications for diarrhea

Answer 3

Loperamide (Imodium)

Diphenoxylate with atropine

Question 4

What does the atropine do in the combo with diphenoxylate?

Answer 4

Reduce abuse potential

Question 5

Loperamide (Imodium) dosing

Answer 5

4mg, then 2mg up to 16mg/day

Question 6

Who should you not use opiate derivative medications in?

Answer 6

Patients with a bacterial infection

Question 7

Side effect of opiate derivatives

Answer 7

Constipation

Question 8

Somatostatin analog

Answer 8

Octreotide

Question 9

Uses for octreotide

Answer 9

Intestinal carcinoid tumors and chemo-induced diarrhea

Question 10

Octreotide route of administration and dosing frequency

Answer 10

SQ as a depo shot q4w

Question 11

Non-pharm options for diarrhea

Answer 11

Pedialyte for little kids
Avoid lactose until resolution
(BRAT diet is NOT recommended)

Question 12

Bismuth subsalicylate (Pepto Bismol) age minimum

Answer 12

> 12 years

There’s a children’s version available but it doesn’t treat the diarrhea

Question 13

Pepto Bismol dosing

Answer 13

524mg q30-60mins PRN up to 8 doses/24 hours

Question 14

Probiotics for diarrhea

Answer 14

May help with C. diff diarrhea, but not recognized by the FDA as medications

Question 15

Digestive enzymes for diarrhea

Answer 15

Lactaid for lactose intolerance

Question 16

Lactaid dosing

Answer 16

1-2 tabs/caps taken with milk or first bite of dairy

Question 17

Lactaid age minimum

Answer 17

> 4 years