Exam 4 - GI Diarrhea

Question 1

Diarrhea definition?

Answer 1

Increase in stool frequency and decrease of consistency compared to baseline.

Question 2

Diarrhea causes an imbalance of what?

Answer 2

Imbalance in absorption and secretion of water and electrolytes in GI tract

Question 3

3 types of diarrhea?

Answer 3

Acute, Persistent, Chronic

Question 4

How long does Acute Diarrhea last for? Causes?

Answer 4

3-7 days. Viral or bacterial.

Question 5

How long does Persistent Diarrhea last for?

Answer 5

14-30 days

Question 6

How long does Chronic Diarrhea last for? Causes?

Answer 6

More than 4 weeks.

IBD, IBS, and Diabetic Neuropathy

Question 7

IBD, IBS, and Diabetic Neuropathy cause what type of diarrhea?

Answer 7

Chronic Diarrhea

Question 8

Which three main meds cause diarrhea?

Answer 8

1. Antibiotics, esp Augmentin
2. Antacids with Magnesium
3. Quinide

Question 9

Do you want to stop a PT from having diarrhea?

Answer 9

Not necessarily. Let C-diff continue pooping to get it out.

Question 10

Weight, serum osmolality, serum electrolytes, CBC, UC, and cultures are useful in assessing what?

Answer 10

Dehydration

Question 11

Community Acquired diarrhea usually caused by what?

Answer 11

Viral illness

Question 12

Causes of Travelers Diarrhea

Answer 12

Viral or bacterial

Question 13

Range when Travelers Diarrhea sets in?

Answer 13

5-15 days after arrival

Question 14

How is Community Acquired Diarrhea treated?

Answer 14

Oral rehydration, bismuth, Loperamide

Question 15

When do use Probiotics?

Answer 15

Only in Post-ABX diarrhea

Question 16

TX for Travelers Diarrhea?

Answer 16

Rehydration, Bismuth, Loperamide, Abx

Question 17

Prophylaxis for Travelers Diarrhea?

Answer 17

Bismuth, ABX (Cipro or Azithromycin)

Question 18

Antimotility MOA and use?

Answer 18

Stimulates intestinal Mu-opioid receptors, inhibits ACh. Decreases intestinal motility, liquid flow, and vagal tone. Increases intestinal absorption and gut transport time.

Acute and Chronic diarrhea.

Question 19

Antimotility CI and warning?

Answer 19

CI: Bloody and infections diarrhea
Warn: Addiction potential d/t being opioid derivative. Don’t use in less than 6 y/o.

Question 20

Examples of Antimotility agents?

Answer 20

Loperamide (Imodium), Diphenoxylate w/ Atropine (Lomotil), Deodorized tincture of Opium, Dicylomine (Bentyl)

Question 21

Adsorbent MOA and use?

Answer 21

Adsorbs bacteria, toxins, and fluids. Decrease stool liquidity and frequency.

Travelers diarrhea.

Question 22

Adsorbent warning and ADR? Example?

Answer 22

Limited ADR d/t minimal absorption. Decreases Warfarin absorption.

Kaolin-Pectin (Kaopectate)

Question 23

Antisecretory MOA and uses?

Answer 23

Modify fluid/electrolyte transport. Adsorbent, antiinflammatory, and antibacterial. Slows motility.

Travelers diarrhea. Gastric tumors.

Question 24

Antisecretory warn and ADR?

Answer 24

Warn: Black tongue and stool, hyperglycemia, impaired fat absorption

Question 25

Examples or antisecretory agents?

Answer 25

Pepto-Bismol, Octreotide

Question 26

Octreotide used for what? Dose does what to motility?

Answer 26

Gastric tumors.
Low dose=increase motility
High dose=decrease motility

Question 27

Microflora MOA and uses?

Answer 27

Nonpathologic bacteria to restore normal intestinal flora.

ABX-associated diarhrea

Question 28

Which drug reduces warfarin absorption?

Answer 28

Kaolin-Pectin, Adsorbent.

Question 29

Which class is an opioid derivative?

Answer 29

Antimotility

Question 30

Tx for watery diarrhea with mild illness?

Answer 30

Loperamide/Immodium

Question 31

Tx for Travel Associated Diarrhea?

Answer 31

Bismuth or Loperamide or ABX

Question 32

Tx for ABX-associated diarrhea?

Answer 32

Loperamide for one day only. Switch ABX or probiotics.

Question 33

Tx for diarrhea with fever, blood, and mucous in stool?

Answer 33

Avoid ALL antidiarrheals. Likely C-diff and need to poop it out.