Diarrhoea Flashcards
Symptoms
Frequent, loose, watery stools
Associated symptoms
Cramps, nausea, flatulence and dehydration
Red flag symptoms
- Unexplained weight loss
- Rectal bleeding
- Persistent diarrhoea
- Systemic illness
- Recent treatment with hospital antibiotics
- Recent travel
Management
Oral rehydration therapy (+ fluids)
Anti-bacterial
Not needed for simple gastroenteritis - self limiting.
Occasionally used for prophylaxis of travellers diarrhoea but routine use is not recommended.
Anti-diarrhoeals
Loperamide
Loperamide + simeticone
Codeine - antimotility drug/opioid
Methylcellulose
Rifaximin
Loperamide
Anti-propulsive
Prolongs duration of GI transit by binding to opioid receptors in GIT
Use
Rapid control of symptoms
Not recommended <12 years
Adult dose
4 mg STAT
2 mg after every loose stool for 5 days
Max dose per day
16 mg
MHRA
Serious CV reactions with high doses, misuse or abuse
- QT prolongation
- Torsades de pointes
- Cardiac arrest
- Fatalities
Side effects (common)
- Dizziness
- Flatulence
- Headache
- Nausea
Contraindications
- Active UC
- C.diff
- Conditions where peristalsis is inhibited
- Conditions where abdominal distention develops
Pharmacists advice
Do not take more than recommended dose on label
Overdose
- Naloxone
- Repeated treatment may be indicated
- Monitor for 48 hours for respiratory depression
