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OTC Exam 3 > Diarrhea > Flashcards

Diarrhea Flashcards

1
Q

Definition

A

Abnormal increase in stool frequency or liquidity

• Abnormal > 3 BM/day

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2
Q

Acute DIA

A

Less than 4 weeks
F&E replacement
Dietary intervention
OTC meds

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3
Q

Chronic DIA

A

More than 4 weeks

Refer

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4
Q

Viral Gastroenteritis

A

Contaminated food/water
Rotavirus
Norovirus

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5
Q

Bacterical Gastroenteritis

A

Can treat
Contaminated food
Traveler’s diarrhea

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6
Q

Protazoal

A

Refer, need antibiotics
Giardia
Cryptosporidium

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7
Q

Drug-induced

A

Antibacterial agents
Cytotoxic agents
Laxatives
Mg products

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8
Q

AIDS-associated

A

Refer

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9
Q

Food-induced

A

Food allergy
Excessively fatty or spicy
High amount of roughage
Lactase deficiency

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10
Q

Complications

A

• Fluid and electrolyte imbalance  dehydration

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11
Q

Mild Dehydration

A 
3-5% wt. loss
<3 unformed stools/day
Mild thirst
Slight dry mouth
Slight  UO
Afebrile/low-grade fever
Normal BP
*Self-treat
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12
Q

Mod Dehydration

A 
6-9% wt. loss
4-5 unformed stools/day
Sunken eyes/fonatanelle
Dry mouth 
 UO/ tearing
Restlessness
Fever >101
Orthostatic BP/pulse 
*Self-treat
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13
Q

Severe Dehydration

A 
10% wt. loss or more
6-9 unformed stools/day
Rapid, thready pulse
Cyanosis
Cold extremities
Rapid breathing
Lethargy and dizziness
Fever > 101
Low BP
Severe abdominal pain
*Refer
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14
Q

who should be referred?

A
  • Chronic medical condition(s)
  • Pregnancy
  • 65 years of age
  • Same or worsening after 48 hours of onset
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15
Q

Treatment Goals

A
  • Prevent or correct fluid and electrolyte loss and acid-base disturbances
  • Relieve symptoms
  • Identify and treat cause
  • Prevent acute morbidity and mortality
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16
Q

General Treatment Approaches

A

Fluid electrolyte balanceDietOTC meds

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17
Q

F&E balance

A

For mild to moderate diarrhea
Carbohydrates- facilitate Na and H2O absorption
Electrolytes

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18
Q

Carbs

A

Glucose
Dextrose
Rice syrup solid
Crystalline fructose

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19
Q

Electrolytes

A 
Sodium 
Chloride
Citrate
Potassium
*Pedialyte is only fluid with an osmolarity 300 will make water go into the GI tract – BAD
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20
Q

General Dosing: Pedialyte

A

• 1-2oz per lb. of body wt over 2-4 hours

  1. 1 tsp q10min x 30min, if tolerated 
  2. 1 tbsp q20min x 1hr, if tolerated
  3. 2 tbsp q30min x 1hr, if tolerated
  4. 4-6oz q 3-4hrs up to 1-2L/day
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21
Q

Pedialyte storage

A

shelf life is 48 hours, throw away after

22
Q

Pedialyte adult dosing

A

: ½ to 1 cup after each loose BM

23
Q

Diet

A

– if oral intake does not worsen diarrhea

24
Q

Diet: infants and children

A

Breast milk, formula, or cow’s milk is OK

25
Q

Diet: foods to eat

A

Carbohydrate-rich (yogurt, lean meats, fruits, vegetables)

BRATTY Diet  not enough calories

26
Q

Diet: Avoid

A

Fatty foods
Foods rich in simple sugars
Spicy foods
Caffeine

27
Q

BRAT Diet

A

BananasRiceApple sauceToastTeaYogurt

28
Q

Prevention

A
  • Isolate for at least 24-48 hours
  • Wash hands
  • Sterilizing techniques
  • Strict food handling practices
  • Sanitation and good hygiene
  • Bismuth Subsalicylate as prophylaxis for Traveler’s diarrhea
29
Q

Loperamide dosing

A

• Imodium AD
2mg/cap
1mg/5mL

• Imodium Advanced
Loperamide - 2mg
Simethacone -125mg

30
Q

Loperamide Dosage and DOA

A
  • 4mg initially, then 2mg after each loose BM (adults)
  • 1/2 dose in children
  • Max: 16 mg/day
  • Children’s max depends on age and wt.
  • DOA: 48 hours
31
Q

Loperamide Indication

A
  • Acute, nonspecific diarrhea
  • Traveler’s diarrhea
  • Chronic diarrhea associated with IBS
32
Q

Loperamide MOA

A

• Slows intestinal motility

33
Q

Loperamide Effects

A
  • decreased daily fecal volume
  • increased viscosity
  • Bulk volume
  • decreased F&E loss
34
Q

Loperamide AE

A
  • decreased CNS poorly
  • Dizziness
  • Constipation
35
Q

Loperamide Contras/warnings

A
  • <6
  • Febrile
  • Blood/mucous in the stool
  • Geriatrics (CNS depression and fatigue)
36
Q

Bismuth Dosage and DOA

A
  • 2 tab qh
  • 30mL q30-60min
  • Max: 16 tab/day or 240mL/day
  • Max: 8 doses/day
  • Labeled for 12 and up
  • DOA: 48 hours
37
Q

Bismuth indications

A 
•	Mild, nonspecific diarrhea
•	Traveler’s Diarrhea 
*2tab or 1fl oz. QID
•	Indigestion
•	H. pylori
38
Q

Bismuth MOA

A
  • Coats the stomach

* Acts like aspirin

39
Q

Bismuth Effects

A
  • decrease frequency of unformed stools
  • increased stool consistency
  • Relieve cramping
  • decreased n&v
40
Q

Bismuth AE

A
  • In combo with other salicylates
  • Tinnitus
  • Reye’s Syndrome
  • Black staining of the stool/tongue
41
Q

Bismuth Contras/warnings

A 
•	Pregnancy
•	Lactation
•	Aids due to neurotoxicity (encephalopathy)
•	Antiplatelet effect
•	Geriatrics –limit use
*Tinnitus or CNS SE
•	Anticoagulants
42
Q

Bismuth interactions: Increased effects

A
  • Warfarin
  • Valproic acid
  • Methotexate
43
Q

Bismuth interactions: decreased effects

A

• Probenecid

44
Q

Bismuth effects: decreased absorption

A
  • Tetracycline

* Fluoroquinolone

45
Q

Helidac

A 
treats duodenal ulcers
•	2 chewable bismuth subsalicylate 262.4 mg
•	1 metronidazole 250mg
•	1 tetracycline 500mg
o	dose above QID x 14days
46
Q

Lactobacillus

A
  • Not considered effective as an anti-diarrheal therapy by FDA
  • Dosed 3-4times/day
47
Q

Acidophilus Tabs

A

• Refrigerate after opening

48
Q

Align

A

• Once a day dosing

49
Q

Lil Critters

A

• BID dosing = 10 servings of yogurt

50
Q

Saccaromyces boularii lyo

A
  • Yeast culture – SE vaginal yeast infection
  • Used in 3 months and up
  • Florator Kids for 2 months and up

OTC Exam 3 (6 decks)

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