Travelers diarrheaMost common causative organisms: E.Coli, E.Histolytica, Gardia Lamblia, CholeraCan be prevented by: ________________________________ ________________________________ ________________________________ ________________________________
Cause SymptomsViral (stomachflu)gastroenteritisNausea, vomiting, watery diarrhea, fever, aches.Usually 1-3 days.BacterialinfectionDiarrhea, fever, chills, sometimes blood or mucus inthe stools. Vomiting less common.Foodintolerance/lactoseintoleranceBloating, gas, cramps, loose stools hours after eatingdairy products or other offending foods. No othersigns of illness or infection.EmotionaldistressCramping, loose stools, predictable during times ofstress.
Diphenoxylate (Lomotil) Loperamide (Imodium)Synthetic drugsChemically related to narcotic meperidineDecrease intestinal motilityTravelers diarrhea
MOAInhibition of acetylcholinerelease through presynapticopioid receptor in the entericnervous system
Therapeutic Indications Severe or prolonged (>2 to 3 days) diarrhea toprevent severe fluid and electrolyte loss Relatively severe diarrhea in young children andelderly adults. In chronic inflammatory diseases of the bowel(Ulcerative Colitis, Crohns disease) In ileostomies or surgical excision of portions ofthe ileum, HIV/AIDS associated diarrhea When specific causes of diarrhea have beendetermined
CONTRA INDICATIONDiarrhea caused bytoxic material,microorganisms,antibiotic associated colitis
Anti cholinergicsDecrease cramping, motility and hyper secretioncombination with opiatesExample:Diphenoxylate + AtropineTwo half lives21/2 h for Diphenoxylate3 to 20 h for atropineOnset of action: 45 to 60 minD.O.A: 3-4 hours