Diarrhoea Treatment

Question 1

What is the 5 steps of setting therapeutic objectives

Answer 1

1. Treat shock & dehydration, prevent dehydration
2. Monitor electrolyte status
3. Prevent complications
4. Decrease diarrhoea duration
5. Decrease recurrence risk

Question 2

What 6 drugs cause diarrhoea

Answer 2

1. Laxatives
2. Mg2+ antacids
3. Antibiotics
4. PPI
5. Lithium/digoxin toxicity
6. SSRI antidepressants

Question 3

What 5 drugs cause constipation

Answer 3

1. Opiate analgesics
2. Al2+ antacids
3. Fe/Ca supplements
4. Diuretics
5. Tricyclic antidepressant

Question 4

What is the recommendations for fluid replacement according to dehydration status

Answer 4

1. Mild dehydration: breast/cow milks if not V
2. Moderate dehydration: small frequent feeds w/ breast milk if tolerated & ORS orally/NG
3. Severe dehydration: intragastric drip or IV infusion

Question 5

At what dosage & why is Zn given

Answer 5

Zinc is given at 10-20mg/day for 10-14 days
Decrease duration, risk of recurrence & dehydration

Question 6

What is the correct measurement for ORS

Answer 6

8 tsp sugar
1/2 tsp salt
1l boiled water

Question 7

What is the 4 instances when antimicrobials are given

Answer 7

1. Severe infection (salmonella, shingella or campylobacter)
2. Cholera
3. Amoebiasis
4. Septicaemia (especially children <2 malnourished & immunocompromised)

Question 8

What type of drug is loperamide

Answer 8

An anti-propulsive medication

Question 9

What is the 3 contra-indications in loperamides & 2 reasons why

Answer 9

Causes:
1. Children under 2 years
2. Infectious diarrhoea
3. IBD
Why:
1. Mask or aggravate dehydration due to fluid retention in bowel
2. Excess sedation in children

Question 10

What is the mechanism of action of loperamide

Answer 10

1. Structurally similar to pethidine & binds to opioid receptor
2. Inhibits contraction in muscle & inhibit presynaptic cholinergic nerves in submucosal & myenteric plexus