Diarrhea & AntiDiarrheal Drugs Flashcards
Oral Rehydration Solution ???
Oral Rehydration Salt + Adequate water = ORS
559
Different types of ORS ??`
- Citrate saline
- Bicarbonate saline
- Rice saline
559
Trisodium Citrate Dihydrate in ORS ?
2.9gm/L
according to lecture slide
NaCl in ORS ?/
2.6 gm/L
KCl in ORS ??
1.5 gm/L
559
Dehydration consequences?
- Shock
- Hypovolemia
- Renal failure
559
Anhydrous glucose in ORS ?/
13.5gm/L
559
Water of the ORS function ??
Corrects fluid loss
Dehydration
559
NaCl & KCl function ??
- Correct electrolyte loss
- Maintain electrolyte balance
559
Citrate function of ORS >??
Trisodium Citrate dehydrate - 2.5gm/L
- inc absoprtion of Na+ & Glucose
- dec stool output
559
HCO3- Bicarbonate function ?/
Correct the acidosis
559
Glucose function of ORS ??
Na+ absorption by Na+ Glucose Co-Transporter
559
Opioid agonists name ??
AntiMotillity drugs name
- Codeine
- Loperamide
- Diphenoxylate
560
A/E of antimotility drugs ??
- Sequestration of fluid in the intestine
- Shock without any diarrhea
- Toxic megacolon
- Abdominal distension
Indiscriminate use of antimotility drugs ??
- Antimotility drugs reduce gastric motility - thats why used in diarrhea
560`
Contraindication of antimotility drugs»_space;??
Should not be used in young childrens and pts with severe colitis
560
Criticize indiscriminate use of antimicrobials in acute diarrhea ??
D caused by Virus Toxins Drugs – NO need of antibiotics
Antibiotics in D when ??
Only if D is caused by Bacteria
Indication of antibiotics ??
- Diagnosed case of cholera
- Dysentry
- Systemic manifestation of endotoxic shock
- Presence of fecal leukocytes (pus cells ) for more than 10/HPF
561
Tx of infective diarrhea ??
- Correction of dehydration
- Correction of electrolyte balance
- Use appropriate antibiotics
Shigella – D - Drugs of 1st choice ?
Quinolones
561
E coli – D – Drugs ??
- Cephalosporin
- TMP-SMZ
561
Complylobacter jejuni - D– Drugs ??
- Arithromycin
- Erythromycin
561
v cholerae ?
tetracycline
ciprofloxacin
Shigella te P drugs ?
Ciprofloxacin
Anti-ulcernat drugs ?
531
sucralfate
misoprostol
colloidal bismuth compund s
PPI is taken before or after meal ?
before meal
why PPI before meal ?
block H/K atpase which are most active post-meal
best absoprtion
empty stomach - inc bioavailabilut
which PPI can be taken anytime >
dexlansoprazole
dual release
misoprostol GI function ?
PUD
which H2 blocker still in use >
famotidine
other than PUD misoprostol function >
induction of labour
faciliation of labour
Tx of PPH
Tx of PUD
Pregnancy safe H2 ?
ranitidine
famotidine
preganancy te kon H1 antiemetic
cyclizine
promethazine
systemic antacid name ?
CaCO3
ALOH3
MgOH3
Mg - trisilicate
A/E of antacids ?
metabolic alkalosis
belching
constipation
osmotic disarrhea
milk alkali syndorme
renal insufficiency
hypercalcemia
anti-emetic drug
551
cytoprotection which drugs ?
same as anti-ulcerant
Severe D te ki korba ?
IV cholera saline
Severe D te ORS diba na ???
NO
pt cannot take that orally
NSAID induce ulcer which one >
PPI
munni mam
which other drug cause ulcer /.
steroid
which drug is used in steroid-induced ulcer <
PPI
misoprostol
steroids + NSAID == ??/
high risk
prophylaxis with PPI
BD te ORS e H2O koto ?
500 C C
2 powa
WHO -ORS water ?
1L
how loperamide act on Diarrhea >
Loperamide acts primarily by binding to opioid receptors in the gastrointestinal tract, inhibiting the release of acetylcholine and prostaglandins. This reduces peristalsis and intestinal secretion, increasing intestinal transit time and allowing for greater absorption of water and electrolytes, thereby alleviating diarrhea. (Source: Katzung & Trevor’s Pharmacology)
inc colonic transit time
inc fecal water absoprtion
dec mass colonic movement ‘
loperamide have anti-secretory action againts cholera toxin
should we use loperamide in D <
yeah
560
not cross BBB
no analgesic
more potent
no addiction
kader loepramide dibo ?
561
M/A of antacid ?
532
domeperidone vs metoclopramide
555
loperamide kader jonno contraindications?
pt with IBD
as they may develop paralytic ileus toxic megacolon