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diarrhea definitions
acute >14 days (self-limiting)
persistent 14 - 4 weeks
chronic >4 weeks
rotavirus vs. norovirus
norovirus
: 24 hour flu; duration 12-60 hours
rotavirus
: infection in toddlers and infants; duration 5-8 days; vaccine prevents 75% cases
clinical diarrhea groups
secretory/watery
osmotic
inflammatory
altered intestinal motility
cause of secretory diarrhea
stimulation of crypt cells
produces influx of electrolytes and water into the lumen
can happen with bacterial and viral enterotoxins and laxatives
cause of osmotic diarrhea
unabsorbed solutes in the intestine that inhibit fluid absorption
stops in fasted state
cause of inflammatory diarrhea
inflammation of intestinal mucosa --> dec absorption of fluid, leakage of blood and pus into lumen
cause of altered intestinal motility diarrhea
premature emptying of intestinal tract b/c too rapid intestinal transit time
usually chronic
pts that get altered intestinal motility diarrhea
diabetic neuropathy
intestinal resection
gastric bypass surgery
IBS
Phase 1 treatment for dehydration
rehydration
for moderate - severe dehydration
severe
: IV fluids
moderate
: ORT
6 months - 5 years
: 50-100 mL/kg over 3-4 hrs
> 5 yo
: 2-4 liters over 3-4 hrs
phase 2 treatment for dehydration
for mild dehydration
give about 10 mL/kg for each stool or emesis
<10 kg
: 60-120 mL
>10 kg
: 120-240 mL
pharmacologic treatment categories for diarrhea treatment
anti-motility agents (opiates or opioid derivatives)
anti-secretory agents
antibiotics
adsorbents
digestive enzymes
intestinal microflora
Loperamide MOA
peripherally acting anti-secretary agent
used to prevent abuse of difenoxin
atropine added
difenoxin MOA
peripherally and centrally acting anti-secretary agent
bismuth subsalicylate MOA
dec freq of unformed stools
inc stool consistency
dec abdominal cramping
direct antimicrobial effects
bismuth subsalicylate AEs
tongue discoloration
dark stools
salicylate toxicity/Reye's syndrome
polycarbophil MOA
adsorbent
absorbs nutrients, drugs, toxins, digestive juices
Author
jcu1
ID
203020
Card Set
Diarrhea
Description
Exam 1
Updated
2013-02-24T20:13:18Z
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