Diarrhoea Flashcards
Define diarrhoea and state how many days acute diarrhoea normally lasts for
1) Abnormal passing of loose or liquid stools, with increased frequency, increased volume, or both.
2) Acute diarrhoea lasts less than 14 days and usually improved within 2-4 days
The presence of which symptoms associated with diarrhoea should prompt immediate investigation?
1) Weight loss
2) Rectal bleeding
3) persistent diarrhoea
4) systemic illness
5) Recent hospital or antibiotic treatment
6) foreign travel (excluding western Europe
north america, Australia or Newzaland)
Most episodes of acute diarrhoea will settle spontaneously but dehydration can become a problem, how should this be managed?
1) Oral rehydration therapy- to prevent or correct diarrhoea dehydration
2) in patients with severe dehydration, immediate admission to hospital and replacement treatment with IV rehydration fluid
which drug can be used to rapidly control the symptoms of diarrhoea?
loperamide can be used to control symptoms and can also be used for mild-to-moderate travellers’ diarrhoea
when should loperamide not be used?
1) Avoided in bloody or suspected inflammatory diarrhoea
2) Significant abdominal pain
3) Avoid in acute ulcerative colitis due to risk of toxic megacolon
4) Avoid in Clostridium difficile colitis including in patients who develop diarrhoea due to broad-spectrum antibiotic use
Apart from the symptomatic treatment of acute diarrhoea, what other indications can lopramide use for?
Loperamide is first-line for faecal incontinence [unlicensed] after the underlying cause of incontinence has been addressed
Outline the MHRA alert regarding the use of loperamide
Reports of serious cardiac adverse reactions with high doses of loperamide associated with abuse or misuse
what drug can be used to treat the symptoms of loperamide overdose?
1) Naloxone can be given as an antidote.
2) The duration of action of loperamide is longer than that of naloxone (1–3 hours), so repeated treatment with naloxone might be indicated
when would racecadotril be prescribed in diarrhoea and what age can it be prescribed from?
1) licensed as an adjunct to rehydration for the symptomatic treatment of uncomplicated acute diarrhoea
2) in adults and children over 3 months.
which antibiotic can be prescribed occasionally as prophylaxis against travellers’ diarrhoea?
Ciprofloxacin
what side effects can loperamide cause?
1) Constipation
2) Abdominal cramping
3) Flatulence
what is the usual dose of loperamide for the treatment of acute diarrhoea
Usual dose is 4mg, followed by 2mg with each loose stool. Max of 8mg (four tablets) per day
