Diarrhea Flashcards
___ liters of fluid enters the proximal small intestine every day
9 L
segmenting contractions delay passage and mix intestinal contents allowing for
greater ___
absorption
T or F: patients with diarrhea have more spontaneous segmenting contractions
False; they have less segementing contractions and less of a chance to absorb nutrients
norovirus is the most common ___ cause of diarrhea and vomiting caused by inflammation in the stomach and intestines
foodborne
DIARRHEA Pathophysiology
Secretory - characterized by a change in active ___ transport by either a ___ in sodium absorptions or an increase in ___ secretion into the lumen
* pancreatic tumors; unabsorbed fat; ___; and bacterial toxins
* large stool volumes (> 1 L/day)
* not altered. by fasting
- ion
- decrease
- chloride
- laxatives
DIARRHEA Pathophysiology
Osmotic - caused when poorly absorbed substances are retained in intestinal fluids; resultng in influx of ___ and electrolytes into the lumen
* ___ intolerance; ___ containing antacids; poorly soluble CHOs like sorbitol and lactulose
* improves with ___
water
* lactose, Mg
* fasting
no eating = no diarrhea
DIARRHEA Pathophysiology
Exudative - subset of ___, secondary to IBD
* IBD discharge mucus, proteins, and blood into the gut
* characterized by ___ stool volumes
secretory
* large
- Diet managment is more important in ___ diarrhea
- BRAT diet
- osmotic
- banana, rice, applesauce, toast
Traveler’s Diarrhea
* ____ therapy should not be used routinely
* ___ may be considered for prevention
* when antibiotic prophylaxis is indicated, ___ is recommended
* ___ are not a recommended antibiotic class for prophylaxis
- antibiotic
- bismuth subsalicylate
- rifaximin
- fluoroquinolones
Treatment Options
Antimotility drugs
MOA: activate ___ opioid receptors on smooth muscle of the bowel to reduce ___ and increase segmentation
* should not be used with ___ diarrhea
- mu
- peristalsis
- C. diff
Antimotility agents
Diphenoxylate/
atropine ( ___ )
* Dose: 5 mg PO ___
* MAX: ___ mg/day
* Rx only, schedule ___
Lomotil
* QID
* 20 mg/day
* V
Antimotility agents
- Difenoxin/atropine ( ___ )
- Dose: 2 mg (2 tabs) PO initially, then 1 tab with each loose stool
- MAX: ___ tabs/day
- Rx only, schedule ___
Motofen
* 8 tabs/day
* IV
Antimotility agents
Loperamide ( ___ )
* Dose: ___ mg initially. then 2 mg after each loose stool
* MAX: ___ mg/day
* OTC
* works ____
* recent concern about potential heart ___
Imodium
* 4 mg
* 16 mg/day
* peripherally
* arrhythmias
T or F: higher than recommened doses of loperamide can cause serious heart problems that can lead to death
True
Absorbents
MOA: absorb nutrients. toxins, drug, and digestive juices
* ___ relief
* used for some patients with ___ diarrhea when they have trouble forming solid poops
* pectin, ___. and attapulgite absorb water and reduce intestinal ___
- symptomatic
- chronic
- kaolin, motility
