OTC - N/V, Diarrhea, 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 pHdirect action which decreases gastric emptying and smooth muscle contractions
What are the antihistamines used to treat nausea from motion sickness?
- meclizine (Antivert)
- diphenhydramine (Benadryl)
- cyclizine (Merizine)
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?
- loperamide (Imodium)
- bismuth subsalicylate (Pepto-Bismol), (Maalox), (Kaopectate)
- 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 six (6) tx options for constipation?
- bulk-forming laxatives
- saline laxatives
- hyper-osmotic agents
MOA of bulk-forming laxatives used for constipation
Cause stool to absorb water and swell stimulating peristalsis & defecation
What are three (3) the bulk-forming laxatives used for constipation?
- methylcellulose (Citrucel)
- psyllium (Metamucil)
What are the emollients used for constipation?
MOA for lubricant laxative used for constipation
Lubricant fecal mass and slows absorption of water from fecal mass
What are the lubricants used for constipation?
What is the MOA of saline laxatives used for constipation?
Increase the osmotic pressure within the intestinal tract to cause more water to enter the intestines
What are the four (4) saline laxatives used for constipation?
- magnesium citrate (Citroma)
- magnesium sulfate
- MOM (milk of magnesia)
- sodium phosphate (Fleet Enema)
What are the MOA of hyperosmotics agents used to prevent constipation?
Increase fecal water content
What are the three (3) hyper-osmotic agents used for constipation?
What is the MOA of stimulants used for constipation?
Increases the peristalsis via the intestine nerve stimulation
What are the three (3) stimulant agents used for constipation?
- sennosides (Senna)
- bisacodyl (Dulcolax)
- castor oil
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?
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