Diarrhoea

Question 1

Acute diarrhoea lasts for less than….

Answer 1

14 days

Question 2

What red flags should you look out for in a patient with diarrhoea?

Answer 2

unexplained wt loss, rectal bleeding, persistent diarrhoea, a systemic illness, previously been in hospital or previously taken antibiotics, has been abroad

Question 3

In what kind of diarrhoea is loperamide not recommended for?

Answer 3

Bloody or suspected inflammatory diarrhoea and in cases of severe ab pains (suggests inflammatory diarrhoea)

Question 4

What condition is loperamide used for as first line despite it being unlicensed?

Answer 4

Faecal incontinence

Question 5

What antibiotic is occasionally used for prophylaxis in travellers diarrhoea?
Flucoxacillin
Cefalaxin
Doxycycline
Ciprofloxacin
Clarithromycin

Answer 5

Ciprofloxacin

Question 6

What are the adverse reactions following loperamide overdose and what actions can you take?

Answer 6

CV events (QT prolongation, cardiac arrest torsaddes de pointes)
Naloxone can be administered, repeated administration may be required as duration of action is less than loperamide (1-3hours)

Question 7

What is the problem with prescribing loperamide capsules to children under 8?

Answer 7

They are unlicensed, the dosage for children 4-7 yrs is 1mg 3-4 times a day. Capsules only come in 2mg.

Question 8

What is the difference in licensing between OTC and POM loperamide?

Answer 8

Can be prescribed for 4yrs and over but can only be sold for over 12 yrs in acute diarrhoea, and over 18s in acute diarrhoea associated with IBS