Shared Flashcard Set

Details

GI infection
Lecture 19
18
Pharmacology
Professional
03/10/2013

Additional Pharmacology Flashcards

 


 

Cards

Term
What is the main outcome of GI infections?
Definition
DIARHHEA!
**The elderly are most at risk for death
Term
What is the general clinical presentation of gastroenteritis?
Definition
Increased fluid output with 3+ watery bowel movements per day
- Acute - lasts less than 2 weeks
- Most food-borne illness from S aureus toxin, other from salmonella or C. diff
Term
What are the differences between watery and inflammatory diarrhea?
Definition
- watery: MOST common, more overall volume, <10/day. Due to cholera, ETEC E. coli
- inflammatory: more stool production (>10/day), higher pH, + guaiac and fecal PMNs. Due to mucosal invasion. Due to shigella, salmonella, EHEC/O157
**Watery can lead to dehydration and shock
Term
How do you evaluate a gastroenteritis patient?
Definition
Poor skin turgor, dry mucous membranes, altered mental status
Na/K/Cl, BUN, SCr
Pearl: if a patient has incr BUN/SCr, ratio will be NORMAL
Term
Who is considered immunocompromised for gastroenteritis?
Definition
chemo, transplant, steroid use, HIV, elderly, uncontrolled diabetes
Term
What is the primary treatment for MILD TO MODERATE dehydration from gastroenteritis?
Definition
Oral rehydration > IV. 75 ml/kg over 4 hours every 2 min
**Saline or lactated ringer preferred
Term
How are antibiotics and antimotility agents used for gastroenteritis?
Definition
- Abx - not essential for mild diarrhea. Have to use appropriate therapy
- Anti-motility - contraindicated in fever, bloody stool, toxin-mediated diarrhea. Can give relief to mild diarrhea.
Term
How are GI infections prevented?
Definition
- Vaccines: 2 typhoid, rotovirus
- reporting: yellow fever, plague, E. coli O157, C. botulinium
- Safe practices and hand washing
Term
What causes viral gastroenteritis?
Definition
- Rotavirus - common cause of diarrhea in kids. Highly contagious. Has a vaccine.
- Norovirus - adults, self-limiting. NON-bloody diarrhea in adults, vomiting in kids.
Produces watery diarrhea
Term
What is Cholera?
Definition
Vibrio cholera - contaminated water causes rice water stools. A large # must be ingested - PPIs increases risk
**Vaccination not required. Tx: replacement of fluids, a single dose of doxy in severe cases
Term
What is E. coli?
Definition
Causes gastroenteritis by enterotoxin production. EHEC/O157 especially virulent.
Tx: rehydration, FQN in severe cases.
Term
What is shigellosis?
Definition
Transmits person to person!
Complications include sepsis and meningitis. Fluid replacement is critical. FQNs can shorten duration
Term
What is salmonellosis?
Definition
Primarily in birds: chicken and turkey. A large # needed for infection
- Carriers: remove their gallbladder
- replace fluids, cipro
Term
What is campylobacteriosis?
Definition
Caused by campylobacter jejuni from contaminated food and water. See bloody diarrhea, fever, vomiting.
TX: fluid replacement, can use macrolides but generally not
Term
What is C. diff?
Definition
- THE most common ANTIBIOTIC-associated diarrhea: cephalosporins, pcns, clinda, fqns
- Transmitted in the hospital. Diagnosis by C. diff toxins in stool
- Tx: metronidazole 500 mg TID x10-14 days, stop other abx. Can use oral vanc.
Term
What is Yersiniosis?
Definition
Thrives in cold weather, from contaminated food.
Tx: fluid replacement, abx when bacteremia develops: FQNs +/- 3rd gen cefs or AG
Term
How is Traveler's diarrhea prevented?
Definition
Peel fruit, piping hot food, pepto bismol, purified water, packaged food
- High risk: FQN or Rifamixin
Term
What should not be used in food poisoning?
Definition
Do NOT use antimotility agents in the presence of fever, bloody diarrhea, or PMNs
Supporting users have an ad free experience!