Antidiarrheals
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| Kaolin: kaolin and pectin | clay like powder that attracts and holds on to bacteria; not systemically absorbed
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| bismuth subsalicylate: Pepto Bismol and Kaopectate | antisecretroy, antimicrobial
used in H.pylori; same contraindications as ASA; used to treat simple diarrhea, chronic infantile diarrhea, traveler's diarrhea
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| opiates: for diarrhea | diphenoxylate with atropine[Lomotil], and diphenoxin with atropine[Motofen], loperamide[Immodium]
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| Lomotil and Immodium should be used cautiously with inflammatory bowel disease and d/c if | abdominal distention occurs
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| Lomotil contraindicated in: | narrow angle glaucoma r/t atropine, caution with prostatic hyperplasia and Down syndrome, not recommended for children <12; should not be used in E.coli, salmonella, shigella, or pseudomembranous colitis
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| none of the drugs has established safety in children less than | 2 years old. Tx is oral rehydration therapy
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| atropine crosses blood brain barrier | Immodium does not
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| Homemade hydrating solutions: | pinch of table salt and 1/2 tsp honey to 8 oz fruit juice for older children and adults;
flat non-diet colas alternate with 8 oz water with 1/4 tsp of baking soda
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| electrolytes commonly lost in acute diarrhea | sodium, K+, bicarbonate, and chloride
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| homemade recipes for children: | 1/4 tsp of sugar free kool aid may be added to pedialyte solutions to help taste;
Jello, water or sports drinks should be avoided b/c they do not contain enough sodium
avoid fruit juices/drinks that contain fructose
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| homemade recipe for infants: | 1/2 cup infant rice cereal mixed with 16 oz water and 1/4 tsp salt
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| evaluation of hydration in infants: | at least 3 wet diapers per 24 hours
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| if diarrhea resolves when milk products or lactose-based formula, withhold products and if... | resolution of diarrhea strongly suggests lactose intolerance
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| meds needed in exacerbation of inflammatory bowel disease: | steroids and sulfasalazine; Immodium along with added fiber in diet and anticholinergics[but if not improvement at 16mg/day for 10 days unlikely to help]
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| only drugs indicated for travelers diarrhea | Pepto, Immodium
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| only drug indicated for inflammatory bowel | Immodim
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