Diarrhoea

Question 1

What are the red flag symptoms of diarrhoea ?

Answer 1

unexplained weight loss
rectal bleeding
persistent diarrhoea
systemic illness
received recent Hospital treatment or antibiotics
or following foreign travel except to Western Europe, Australia, North America or New Zealand

Question 2

Name antidiarrhoeals ?

Answer 2

codeine
co-phenotrope
loperamide
loperamide with simeticone
kaolin
methylcellulose
racecadotril
rifamixin

Question 3

How does loperamide work ?

Answer 3

anti propulsive. prolongs the duration of intestinal transit by binding to opioid receptors in the gastrointestinal tract.

Question 4

What is the dosing regimen for loperamide ?

Answer 4

Initially 4 mg, followed by 2 mg for up to 5 days, dose to be taken after each loose stool; usual dose 6–8 mg daily; maximum 16 mg per day.

Question 5

What is MHRA advice regarding Loperamide ?

Answer 5

Serious cardiovascular events (such as QT prolongation, torsades de pointes, and cardiac arrest), including fatalities, have been reported in association with large overdoses of loperamide.
if symptoms of overdose occur, naloxone can be given as an antidote.
The duration of action of loperamide is longer than that of naloxone (1–3 hours), so repeated treatment with naloxone might be indicated; patients should be monitored closely for at least 48 hours to detect possible CNS depression.

Question 6

What are the common side effects of loperamide ?

Answer 6

dizziness, flatulence, headache and nausea

Question 7

What are the contraindications of loperamide ?

Answer 7

active ulcerative colitis
antibiotic associated colitis
conditions where peristalsis is inhibited
conditions where abdominal distension develops