Gastroenteritis Flashcards
Gastroenteritis definition
Inflammation of the stomach and intestines due to viral infection or
bacterial/protozoal toxins which causes vomiting and diarrhea
Common symptoms
Nausea, vommiting, fever, diarrhea
Don’t self treat gastroeneritis
-less than 6 months or weigh less than 17.5 pounds
-blood in stool
severe pain, fever…
-risk for complication
pregnancy
–no improvment after 48 hours
Non pharmacologic treatment
-Fluid and electrolye management(self care, commercial products, household products
-Adults: ORS reccomended but little evidence for minor cases of diarrhea
Dietary management
avoid fatty foods, spicy foods, and caffeine, BRAT is not reccomended
OTC treatment option
loperamide and bismuth subssalcylate
Loperamide MOA
stimulates peripheral micro-opioid receptors on intestinal circular muscles
to slow motility so water & electrolytes can be absorbed
Loperamide pharmacodynamics
inset withi 1 hour, duration-up to 3 days
Loperamide drug interactions
quinidine, ketoconazole, ritonavir, protease inhibitors,
cyclosporine, erythromycin, clarithromycin, saquinavir, St. John’s wort
Loperamide dosing
-adults: 4 mg initially, another 2 mg after each loose stool(max 8 mg/24 hours)
-children(6-8): 2 mg initially, then 1 mg after each loose stool, max 4 mg/24 hours
-(9-11)- 2 mg initially, then 1 mg after each loose stool, max 6 mg/24 hours
Bismuth subsalicylate MOA
inhibition of prostaglandin synthesis, stimulation of sodium & potassium
reabsorption
Bismuth subsalicylate pharmacodynamics
onset within 30 min-4 hours
Avoid bismuth subsalicylate
gout, asthma-associated bronchospasm; if recovering from chickenpox or
influenza-like illness; within 6 weeks of chickenpox or influenza vaccine
Bismuth subsalcylate dosing
Adults: 525 mg every 30-60 minutes up to 4200 mg/day
