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What are the exclusions for self treatment of Nausea/vomiting?
- Lactation
- Suspected food poisoning
- Severe abdominal pain
- Blood in vomit
- Stiff neck
- Recent head trauma
- Glaucoma, BPH, Chronic respiratory distress
- Yellow skin
- Dehydration in children
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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
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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
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What is the MOA of antacids for nausea of overindulgence?
increase pH by acid neutralization
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What is the MOA of H2 antagonists for nausea of overindulgence?
- compete with H2 at receptor sites
- decreased acid secretion
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What is the MOA of PPIs for nausea of overindulgence?
shut down acid pumps
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What is the MOA of bismuth for nausea of overindulgence?
unknown
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What is the MOA of phosphorated carbohydrate solution for nausea of overindulgence?
- adjusts pH
- direct action which decreases gastric emptying and smooth muscle contractions
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What are the antihistamines used to treat nausea from motion sickness?
- meclizine
- dimenhydramine
- diphenhydramine
- cyclizine
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When should antihistamines be taken for treatment of nausea from motion sickness?
30-60 min prior to travel
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What is the treatment for nausea attributed to pregnancy?
- Dietary changes
- Fresh air
- Avoiding unpleasant scents
- Accupressure/acustimulation
- Antihistamines (severe cases only)
- Pyridoxine (B6) (2nd to non-drug tx)
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What are the tx for diarrhea?
- loperamide
- bismuth subsalicylate
- lactase enzymes
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What are the age restrictions for loperamide tx for diarrhea?
< 6yo
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What are the age restrictions for bismuth tx for diarrhea?
12 and older only
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What are the SE of loperamide?
- dizziness
- constipation
- abdominal pain
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What are the SE of bismuth?
- tinnitus
- Reye's syndrome
- gout attacks
- black stool
- black tongue
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What are the tx options for constipation?
- bulk-forming laxatives
- emollient
- lubricant
- saline laxatives
- hyper-osmotic agents
- stimulants
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What are the bulk-forming laxatives used for constipation?
- methylcellulose
- polycarbophil
- psyllium
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What are the emollients used for constipation?
docusate
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What are the lubricants used for constipation?
mineral oil
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What are the saline laxatives used for constipation?
-
What are the hyper-osmotic agents used for constipation?
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What are the stimulant agents used for constipation?
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Which agents used for constipation should not be used in kids < 6yo?
- methylcellulose
- polycarbophil
- psyllium
- docusate
- mineral oil
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What is the DOC for constipation in long-term opiate users?
stimulants (senna, bisacodyl)
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What is the best agent to use for constipation in pregnancy?
docusate
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