Each week we will aim to bring out a concise email that provides 4-5 key pieces of information addressing a specific issue in clinical therapeutics.
This week: Drugs and diarrhoea (part 1)
Diarrhoea is characterised by increased volume, fluidity or frequency of faecal discharges. Acute diarrhoea is commonly infectious and can be viral (e.g. rotavirus, norovirus), bacterial (often causing food poisoning) or parasitic and is usually associated with nausea & vomiting. In some health service jurisdictions, infections with specific organisms are notifiable.
- The use of antimotility agents for infectious diarrhoea is not routinely recommended because the infectious agent and associated toxins will remain in the GI tract longer. Rehydration and electrolyte replacement are the mainstays of treatment. Oral rehydration solutions contain sodium, potassium, glucose and water plus alkalinising agent; under usual circumstances a sachet is given after each loose bowel motion.
- cholinergic agents e.g. donepezil
- chemotherapy affecting the lining of the GI tract e.g. 5-fluorouracil, capecitabine
- prokinetic agents such as metoclopramide
- magnesium-containing antacids and supplements
- situations associated with increased osmotic load in GI tract e.g. enteral feeds
Please consider these issues when preparing or interpreting RMMR reports or education sessions. Contributions of content or suggested topics are welcome and should be sent directly to firstname.lastname@example.org.