Time Completed: 01:08:33
Final Score 46%
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Acute Diarrhoea
Pharmacology / Gastrointestinal
Last Updated: 26th March 2019
Acute Diarrhoea
The priority in the management of acute diarrhoea, such as in gastroenteritis, is the prevention or reversal of fluid and electrolyte depletion. This is particularly important in infants, and in frail and elderly patients. Oral rehydration preparations may be used, or in more severe cases patients may be admitted to hospital and given intravenous fluid and electrolyte replacement.
Antimotility Drugs
Antimotility drugs can relieve symptoms of acute diarrhoea by decreasing intestinal secretion and motility, prolonging intestinal transit time and facilitating water reabsorption (e.g. loperamide acting on opioid mu-receptors).
They may be used in the management of uncomplicated acute diarrhoea in adults but are not recommended for acute diarrhoea in young children.
Antimotility drugs are contraindicated in active ulcerative colitis, antibiotic-associated colitis and conditions where abdominal distension develops or where inhibition of peristalsis should be avoided.
Antispasmodics
Antispasmodics are occasionally of value in treating abdominal cramp associated with diarrhoea in adults but they should not be used for primary treatment.
Antispasmodics and antiemetics should be avoided in young children with gastroenteritis because they are rarely effective and have troublesome side effects.
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- Biochemistry
- Blood Gases
- Haematology
| Biochemistry | Normal Value |
|---|---|
| Sodium | 135 – 145 mmol/l |
| Potassium | 3.0 – 4.5 mmol/l |
| Urea | 2.5 – 7.5 mmol/l |
| Glucose | 3.5 – 5.0 mmol/l |
| Creatinine | 35 – 135 μmol/l |
| Alanine Aminotransferase (ALT) | 5 – 35 U/l |
| Gamma-glutamyl Transferase (GGT) | < 65 U/l |
| Alkaline Phosphatase (ALP) | 30 – 135 U/l |
| Aspartate Aminotransferase (AST) | < 40 U/l |
| Total Protein | 60 – 80 g/l |
| Albumin | 35 – 50 g/l |
| Globulin | 2.4 – 3.5 g/dl |
| Amylase | < 70 U/l |
| Total Bilirubin | 3 – 17 μmol/l |
| Calcium | 2.1 – 2.5 mmol/l |
| Chloride | 95 – 105 mmol/l |
| Phosphate | 0.8 – 1.4 mmol/l |
| Haematology | Normal Value |
|---|---|
| Haemoglobin | 11.5 – 16.6 g/dl |
| White Blood Cells | 4.0 – 11.0 x 109/l |
| Platelets | 150 – 450 x 109/l |
| MCV | 80 – 96 fl |
| MCHC | 32 – 36 g/dl |
| Neutrophils | 2.0 – 7.5 x 109/l |
| Lymphocytes | 1.5 – 4.0 x 109/l |
| Monocytes | 0.3 – 1.0 x 109/l |
| Eosinophils | 0.1 – 0.5 x 109/l |
| Basophils | < 0.2 x 109/l |
| Reticulocytes | < 2% |
| Haematocrit | 0.35 – 0.49 |
| Red Cell Distribution Width | 11 – 15% |
| Blood Gases | Normal Value |
|---|---|
| pH | 7.35 – 7.45 |
| pO2 | 11 – 14 kPa |
| pCO2 | 4.5 – 6.0 kPa |
| Base Excess | -2 – +2 mmol/l |
| Bicarbonate | 24 – 30 mmol/l |
| Lactate | < 2 mmol/l |
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