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OTC > Diarrhea > Flashcards

Diarrhea Flashcards

1
Q

Characteristic of diarrhea:

A

abnormal increase in stool frequency, liquidity, or weight

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2
Q

How many bowel movements per day is considered abnormal?

A

more than 3

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3
Q

What counts as acute diarrhea?

A

symptoms that last less than 14 days

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4
Q

How to treat acute diarrhea:

A
  • fluid and electrolyte replacement
  • dietary interventions
  • nonrx drug treatment
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5
Q

What counts as persistent diarrhea?

A

symptoms that lasts 14 days to 4 weeks

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6
Q

What counts as chronic diarrhea?

A

symptoms that lasts more than 4 weeks

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7
Q

Persistent and chronic diarrhea are…

A

secondary to other medical conditions or treatments

- need to refer

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8
Q

What is the most common cause of diarrhea in adults?

A

noroviruses

- plays major role in sporadic acute gastroenteritis

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9
Q

What is the most common cause of severe gastroenteritis infants and young children?

A

rotavirus

  • two oral vaccines are available
  • seasonal infection w/ peaks between nov-feb
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10
Q

Most cases of bacterial gastroenteritis result from…

A

food-borne transmission

- pathogens: salmonella, shigella, e. coli, clostridium perfringens, staph aureus

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11
Q

What is responsible for most cases of traveler’s diarrhea?

A

e. coli

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12
Q

Symptoms of traveler’s diarrhea usually subsides over..

A

3-5 days

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13
Q

Disease of small intestine is indicated by…

A

undigested food particles in stool

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14
Q

Upper GI bleeding is indicated by…

A

black, tarry stools

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15
Q

Red stools may indicate…

A

lower bowel or hemorrhoid bleeding or red foods or drugs

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16
Q

Yellow stools indicate…

A

presence of bilirubin and potentially serious liver problem

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17
Q

Whitish tint to stool indicates…

A

fat malabsorption disease

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18
Q

What are the major complications of diarrheal illness?

A

fluid and electrolyte imbalance

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19
Q

What is a key factor in determining if self-care is appropriate?

A

assessment of patient’s risk for dehydration and the degree of dehydration present

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20
Q

Signs and symptoms of minimal or no dehydration:

A
  • < 3% loss of body weight
  • alert
  • drinks normally
  • normal heart rate
  • normal urine output
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21
Q

Signs and symptoms of mild-moderate dehydration:

A
  • 3-9% loss of body weight
  • restlessness
  • irritable
  • thirsty
  • normal-increased heart rate
  • decreased urine output
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22
Q

Signs and symptoms of severe dehydration:

A
  • > 9% loss of body weight
  • lethargic
  • unable to drink
  • increased heart rate
  • minimal urine output
  • not self-treatable
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23
Q

Initial self-management for mild-moderate, uncomplicated diarrhea should focus on..

A

fluid and electrolyte replacement

24
Q

Exclusions to self-treatment:

A
  • < 6 months old
  • > 6 months w/ persistent fever
  • children w/ severe dehydration
  • blood, mucus, or pus in stool
  • protracted vomiting
  • severe abdominal pain
  • pregnancy
25
Q

Non-pharmacologic therapy:

A
  • fluid and electrolyte management
  • dietary management
  • preventive measures
26
Q

Examples of electrolytes:

A
  • sodium
  • chloride
  • citrate
  • potassium
27
Q

What are the two phases for fluid and electrolyte management?

A
  • rehydration

- maintenance therapy

28
Q

Rehydration phase of fluid and electrolyte management is when…

A

one quickly replenishes water and electrolyte deficits over 3-4 H

29
Q

Maintenance therapy phase of fluid and electrolyte management is when…

A

electrolyte solutions are given to maintain normal body composition until dietary intake is reestablished

30
Q

Examples of fluid and electrolyte management:

A
  • Pedialyte
  • Enfamil enfalyte solution
  • ceralyte powder packets
  • usually for children
31
Q

T/F: there is little evidence that supports use of oral rehydration solutions (ORS) in adults

A

T

32
Q

Since ORS has little effect in adults, what are other ways they can increase fluid and electrolytes?

A
  • clear juices
  • soups
  • sports drinks
33
Q

For dietary management, it’s recommended that you withhold food for no longer than…

A

24 H and encourage reintroduction of normal diet once patient has been rehydrated (3-4H)

34
Q

Avoid _____ diet while having mild-moderate diarrhea

A

BRAT, which is bananas, rice, applesauce, and toast

- insufficient calories, protein, and fat

35
Q

Examples of foods to avoid:

A
  • fatty
  • sugary
  • spicy
36
Q

What are some appropriate food options for a patient with mild-moderate diarrhea?

A
  • carb-rich
  • yogurt
  • lean meats
  • fruits
  • vegetables
37
Q

Examples of preventative measures:

A
  • isolate individual with symptoms
  • wash hands
  • strict food handling
38
Q

Pharmacologic treatments:

A
  • loperamide
  • bismuth subsalicylate (BSS)
  • digestive enzymes
39
Q

Loperamide dosages:

A

4 mg initially, then 2 mg after each loose stool

  • don’t exceed 8 mg/day
  • not for children < 6 YO
40
Q

Duration of use for loperamide:

A

48 H

41
Q

Bismuth subsalicylate dosages:

A

525 mg every 30-60 min, up to 4200 mg/day

  • max: 8 doses/day
  • not for children < 12 YO
42
Q

Digestive enzyme dosages:

A
  • liquid: 5-15 drops placed/taken with dairy product
  • 1-3 tab or 1-2 cap with 1st bite of dairy product
  • children is the same dosage
43
Q

Duration of use for bismuth subsalicylate dosages:

A

48 H

44
Q

Duration of use for digestive enzyme dosages:

A

take with each consumption of dairy product

45
Q

Loperamide is an effective antidiarrheal agent in…

A

traveler’s diarrhea

46
Q

Side effects of loperamide:

A
  • dizziness
  • constipation
  • abdominal pain
  • dry mouth
47
Q

Examples of loperamide:

A
  • Imodium A-D

- Imodium Advanced Formula Caplets

48
Q

Bismuth subsalicylate is an effective antidiarrheal agent in…

A

traveler’s disease and Helicobacter pylori (associated with peptic ulcer disease)

49
Q

Patients who take bismuth subsalicylate should be cautious when taking…

A

aspirin or other drugs with salicylate b/c toxic levels of salicylate may be reached

50
Q

Adverse effects of bismuth subsalicylate:

A
  • mild tinnitus (dose related)
  • Reye’s syndrome
  • neurotoxicity
  • harmless black staining of stool or tongue
51
Q

Drug interactions with bismuth subsalicylate:

A
  • warfarin
  • valproic acid
  • methotrexate
  • tetracyclines
  • quinolones
  • same as ones for aspirin
52
Q

Examples of bismuth subsalicylate:

A
  • pepto bismol
  • kaopectate
  • maalox
53
Q

Examples of digestive enzymes:

A
  • lactaid
  • lacteez drops
  • lactrase capsules
54
Q

For children 5 YO and under, they should only treat with…

A

oral rehydration solutions

- medications not recommended

55
Q

For elderly people 65 and older, they should be strongly cautioned against…

A

self-treatment with medications b/c reactions are more likely to be severe or possible fatal

56
Q

If one is pregnant, they should be…

A

referred to MD

57
Q

When should you refer a patient after treatment?

A

if it hasn’t been resolved after 72 H of treatment

OTC (23 decks)

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