PC 707 Module 3 Exam - Questions and Answers What is traveler's diarrhea? -bacterial or parasitic -usually lasts 2-3 days -self limiting usually -only
... [Show More] treat if severely ill, high fever, or lasts >7 days What treatment options are available for travelers diarrhea? -if bacterial--first line is now a macrolide (azthromycin)* -if salmonella, giardia, E. histolyic--Flagyl could be used (no alcohol with use)* Should you treat every person with travelers diarrhea? -there is faster relief with antibiotics & anti motility drugs -however, do not treat unless it's severe -it may cause acute retention of the offending pathogen Would you give a patient an antibiotic to "prevent" travelers diarrhea before they travel? -NO -this leads to antibiotic resistance What is the first line anti-motility drug in pregnancy & lactation? -loperamide (Imodium)-category B--minimal oral absorption and minimal in breast milk AVOID Pepto-Bismol in pregnancy & lactation due to salicylate content What are some potential herbals that could be used for constipation? -black psyllium -blond psyllium -prunes Black psyllium: -can be used for constipation -adverse effects are transient flatulence & abdominal distention -make sure to consume enough water to avoid esophageal & bowel obstructions* Blond psyllium: -can be used for constipation -as effective as Senokot & Colace -not as effective as prunes* Prunes: -can be used for mild or moderate constipation -safe, palatable, and more effective than psyllium What is irritable bowel syndrome (IBS)? -functional -no specific organic pathology -abdominal pain, altered bowel habits, and abdominal distention -can be predominately constipation, diarrhea, or alternating -said to have "excessive" bacteria -goals are symptom relief* What treatments are available for IBS? -exercise -broad spectrum antibiotics (rifaximin-Xifaxan)--to help "reduce" the number of bacteria colonizing--to decrease symptoms -antispasmodics (dicyclomine-Bentyl) -peppermint oil -probiotics (bifidobacteria) -diet changes (low FODMAP) -antidepressant (SSRIs & try-cyclic)--decreases abdominal pain unrelated to decreasing depression* -anti-diarrheals (loperamide-Imodium) Why is a FODMAP used in treatment of IBS? -"fermentable, oligosaccharides, disaccharides, monosaccharides, and polyols" -foods high in these often cause bloating, abdominal pain, gas -eliminate all foods high in these for 3-8 weeks then slowly reintroduce them into diet to determine which are tolerable and which aren't What are the effectiveness of probiotics? -the effectiveness is species, dose, and disease specific -can help stabilize the "normal gut flora" -they can help decrease flatulence and abdominal pain Contraindicated in those who are immunocompromised What are the two most commonly used probiotics? -Bifidobacteria or Lactobacillus -combination of both What if you are giving probiotics and antibiotics? -always space probiotics 2 hours from antibiotics What is Bifidobacteria? -part of the normal gut flora -used as a probiotic -can be effective for IBS -when used as an adjunctive in tx of H. Pylori--especially in combo with lactobacillus can reduce effects from treatment -can increase remission rates in ulcerative colitis -can usually notice effects in 1 week -can reduce abdominal pain, bloating, bowel routine difficulty, and constipation -must store in fridge -must continue using for continued effects What is lactobacillus? -part of the normal gut flora -used as a probiotic -used to prevent and treat GI distress -can prevent infectious diarrhea -can prevent and treat antibiotic associated diarrhea -used as adjunctive in tx of H. Pylori -possibly safe in lactation & pregnancy Nausea and vomiting? When do you treat? -common, usually self-limiting, most don't need tx -goal is symptom relief, prevent dehydration, and selection of drug is based on cause of symptoms What treatment options are available for N/V? [Show Less]