NVD and Constipation
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What are the exclusions for self treatment of Nausea/vomiting?
- Suspected food poisoning
- Severe abdominal pain
- Blood in vomit
- Stiff neck
- Recent head trauma
- Glaucoma, BPH, Chronic respiratory distress
- Yellow skin
- Dehydration in children
What are the exclusions for self-treatment of diarrhea?
- < 6mo old
- severe dehydration
- > 6mo with persistent fever > 102.2
- Blood, pus, mucus in stool
- > 48h duration
- severe abdominal pain
- Risks for complications (DM, CVD/renal disease, Cancer tx, Immunocompromise, pregnancy)
- suspected protozoal infection
What are the exclusions for self-treatment of constipation?
- sudden changes in stool
- recent weight loss
- abdominal pain, N/V (appendicitis sx)
- blood in stool
- painful anal or rectal conditions
What is the MOA of antacids for nausea of overindulgence?
increase pH by acid neutralization
What is the MOA of H2 antagonists for nausea of overindulgence?
- compete with H2 at receptor sites
- decreased acid secretion
What is the MOA of PPIs for nausea of overindulgence?
shut down acid pumps
What is the MOA of bismuth for nausea of overindulgence?
What is the MOA of phosphorated carbohydrate solution for nausea of overindulgence?
- adjusts pH
- direct action which decreases gastric emptying and smooth muscle contractions
What are the antihistamines used to treat nausea from motion sickness?
When should antihistamines be taken for treatment of nausea from motion sickness?
30-60 min prior to travel
What is the treatment for nausea attributed to pregnancy?
- Dietary changes
- Fresh air
- Avoiding unpleasant scents
- Antihistamines (severe cases only)
- Pyridoxine (B6) (2nd to non-drug tx)
What are the tx for diarrhea?
- bismuth subsalicylate
- lactase enzymes
What are the age restrictions for loperamide tx for diarrhea?
What are the age restrictions for bismuth tx for diarrhea?
12 and older only
What are the SE of loperamide?
- abdominal pain
What are the SE of bismuth?
- Reye's syndrome
- gout attacks
- black stool
- black tongue
What are the tx options for constipation?
- bulk-forming laxatives
- saline laxatives
- hyper-osmotic agents
What are the bulk-forming laxatives used for constipation?
What are the emollients used for constipation?
What are the lubricants used for constipation?
What are the saline laxatives used for constipation?
What are the hyper-osmotic agents used for constipation?
What are the stimulant agents used for constipation?
Which agents used for constipation should not be used in kids < 6yo?
- mineral oil
What is the DOC for constipation in long-term opiate users?
stimulants (senna, bisacodyl)
What is the best agent to use for constipation in pregnancy?
What would you like to do?
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