Diarrhoea Flashcards
Does diarrhoea require a counselling room?
Yes
What are 11 red flags for referral with diarrhoea?
- Diarrhoea alternating with constipation
- Diarrhoea occurring intermittently
- Blood or mucous in stools
- Diarrhoea > 14 days
- Severe symptoms (8-10 motions, or 2-3 large motions per day)
- Systemic symptoms (for example, fever, vomiting)
- Severe abdominal pain
- Inability to tolerate food/drink
- Unintentional weight loss
- Recent travel abroad
- Refer infants (< 1 year) due to high risk of dehydration
Does diarrhoea have a PSA self-care card?
Yes (Vomiting and diarrhoea)
What is the preferred over-the-counter treatment option for diarrhoea?
Oral Rehydration Salts (Hydralyte) ± loperamide (if necessary)
What are the directions for Gastro-Stop (loperamide) in diarrhoea?
Adults and children over 12 years: 2 stat then 1 tablet after each loose bowel motion. Maximum 8 tablets (16mg) in a day.
What are 6 potential adverse effects of loperamide?
- Abdominal pain
- Bloating
- Nausea
- Vomiting
- Constipation
- CNS/respiratory depression (at high doses).
What is 1 non-preferred over-the-counter option for diarrhoea and why?
Diphenoxylate + Atropine (Lomotil): less effective, higher risk in late pregnancy
Is Gastro-Stop (loperamide) safe in pregnancy?
Yes (when limited to 1 to 2 doses)
Is Gastro-Stop (loperamide) safe in breastfeeding?
Yes (when limited to 1 to 2 doses)
What is the age range for Gastro-Stop (loperamide)?
Safe in children over 12 years
What are 9 pieces of non-pharmacological advice for diarrhoea?
- Rest
- Sip slowly as frequently as possible to maintain hydration
- Manage other symptoms if present for example, fever, nausea, diarrhoea, etc.
- Rest
- Replace fluids and electrolytes
- Normal food intake may start after rehydration
- Should only use opioid antidiarrhoeals when necessary (for example, work, travelling) as it may delay expulsion of organism
- Maintain adequate hygiene to reduce transmission of infectious diarrhoea pathogens (Regular handwashing).
- Avoid dairy products for duration of the diarrhoea, particularly in children
What are 9 symptoms of dehydration?
- Dry mouth
- Thirst
- Decreased urine output
- Sunken eyes
- Deep breathing
- Decreased skin elasticity
- Rapid pulse
- Low BP
- Sunken fontanelle (children)
What is the typical duration of diarrhoea?
Acute diarrhoea is generally self- limiting and resolves after 1 to 2 days without treatment.
How should diarrhoea in children be managed?
Anti-diarrhoeals should not be used in children, treat with fluid and electrolytes.
What are 8 medications which can induce diarrhoea?
- Acarbose
- Antibiotics
- Colchicine
- Cytotoxic agents
- Digoxin
- Magnesium-containing antacids
- Metformin
- Thyroxine
