Diarrhoea

Question 1

diarrhoea symptoms

Answer 1

frequent loose, watery stools
~ N, cramps, flatulence
~ dehydration

Question 2

RED FLAG symptoms for diarrhoea

Answer 2

~ unexplained weight loss
~ rectal bleeding
~ persistent diarrhea
~ systemic illness
~ recent hospital tx or antibiotics tx or foreign travel

Question 3

anti-diarrhoeal

Answer 3

~ codeine (opioid, anti-motility)
~ loperamide
~ kaolin ( + morphine)
~ methylcellulose
~ rifamixin (used in travellers diarrhoea)

Question 4

Diarrhoea 1st line

Answer 4

oral rehydration therapy

Question 5

Loperamide MOA

Answer 5

anti-proplusive, prolongs duration of intestinal transit by binding to opioid receptors in GIT

Question 6

Loperamide use

Answer 6

~ standard tx for rapid symptom control
~ not recommended for <12y

Question 7

Loperamide dose

Answer 7

initially 4mg, then 2mg up to 5 days, after each loose stool
MAX 16mg (8 caps)

Question 8

Loperamide MHRA alert

Answer 8

serious cardiac adverse reactions with high doses
QT prolongation, torsades de pointes, cardiac arrest
Naloxone = antidote for abuse

Question 9

Loperamide SE

Answer 9

Dizziness
Flatulence
Headache
Nausea

Question 10

Loperamide contra-indication

Answer 10

~ active UC
~ ABx associated colitis
~ no gut motility
~ distended abdomen

AVOID IN BLOODY DIARRHOEA OR INFLAMMATORY DIARRHOEA