Diarrhoea(Part 2)

7/25/2019 Diarrhoea(Part 2)

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DIARRHOEA

( 2 )


2/31

ANTIMICROBIAL

1. Cholera

2. Shigellosis3. Amoebiasis

4. Giardiasis

Acute Diarrhoea

(WHO)


3/31

ANTIMICROBIAL (WHO)

1. CHOLERA TETRACYCLIN 12,5 mg/Kg BW - 4 x a day

3 days

2. HI!ELLA "YENTERY 5 mg T#$ % 25 mg #&/Kg BW - 2 x a day

5 days

3. A#OEBIAI #ETRONI"A'OLE 1(mg/Kg BW - 3 x a day

5 days

4. !IAR"IAI #ETRONI"A'OLE 5 mg / Kg BW - 3 x a day

5 days


4/31

SIDE EFFECT OF ANTIMICROBIAL

1. CHANGING OF INTESTINAL FLORA2. OVERGROWTH:

- MONILIA

- ENTEROCOCCUS

- ANAEROB- PSEUDOMONAS

3. MUCOSAL INJURY

. IRRITATION!. PSEUDOMEMBRANOUS ENTEROCOLITIS

". BLOOD DYSCRASIA

#. VOMITING


5/31

ANTI"IARRHOEAL)*+d as .".A0

1. B$%&' M$&&*+

2. S+$$' C$*,,+&*/

3. C0,

A dg a a+ s67+ y 689

masm+ 6 a 6 6+6: sym;6ms6< da6a


6/31

1.UNABSORBEDANTIMICROBIAL :

StreptomycinNeomycin

Hydroxy!ino"inUn#$%or$ed S!"

'. ANTIMOTILIT( :) Loper#mide) Dip*enoxy"#te

+. ADSORBENT :,#o"in-pectinC*#rco#"At#p!"it - %mectite

/. ANTISECRETOR( :S#"icy"#te AcidC*"orprom#0ine

. TRIAL:L#cto$#ci""!%23r!ctoo"io %#cc*#rid#

Antidi#rr*oe#"

NB : 1 to / NO RECOMMENDED


7/31

AOLIN

1. S+4'+& 0'-+,,4& &*&+0+$*

2. N$ 5&*&6+ * 0$*7 ,+$$', $*,,+&*/3. S40&,, +8& &66&+ $6 *+5$+,

. C$,&+ &66&+

!. M'5,$0+$*

IODOHIDRO9Y UINOLINE

1. N$ 5&*&6+

2. I* J* ;;< S454+& M/&'$ O+ N&40$+8/

( SMON)


8/31

DIARRHOEA

DEHYDRATION COMPLICATION

REHYDRATION

-RINGER=S LACTATE-RINGER=S ACETATE

-ORS

- ELECTROLYTES

IMBALANCE- ACIDOSIS METABOLIC

- FEVER

- CONVULTION- HYPOGLICEMIA


9/31

OPIATES > SPASMOLYTICA

1. INCREASE THE DURATION OF FEVER2. PROLONG PASSAGE OF PATHOGENS

3. DECREASE OF BOWEL PERISTALSIS

. INCREASE THE DURATION OF

PROLIFERATION?TOSIN PRODUCTION >

INVASIVE BY MICROORGANISMS

!. GUTPARALYSIS


10/31

ELECTROLYTES - ACID BASE

INITIAL

DIAGNOSIS

REHYDRATION

TREATMENT


11/31

ELECTROLYTE = ACI" BAE

INITIAL

IONATRE#IA"EHY"RATION

REHY"RATION

HY$ONATRE#IA

"IL*TIONAL


12/31

REHYDRATION

ACIDOSIS METABOLIC

H @ #.2

HCO3-; 1-2 E7 BW

- LUNGS DYSFUNCTION (-)

- HYPOALEMIA (-)

DEHYDRATION ACIDOSIS METABOLIC


13/31

REHYDRATION

HYPERNATREMIA

( < 1! E')

- IVFD STOPPED

- PLAIN WATER

DEHYDRATION HYPERNATREMIA


14/31

REHYDRATION

HYPONATREMIA

( @ 13! EL)

S/+

H/$N

A6+&0

R&8/0+$*

A,/+

H/$N

NC' 3 F'4 R&,+0+$*RL

N(E); (13! N',) ?" BW (7)

DEHYDRATION HYPONATREMIA


15/31

REHYDRATION

HYPOALEMIA

D008$& () D008$&

HYPERALEMIA

R&*' F4*+$*

ECGRL

N 5N

$0' 0(4+$ 3 E 7BW /)

A4+& R&*' F'40&

F'4,

R&,+0+$*

DEHYDRATION HYPO HYPERALEMIA


16/31

FEVER

TEMPERATURE DOWN

COOLING DRUGS

- U*'$+8&

- W& $6 ,%&+

- F***7

- T& ,$*7*7

1. P0&+$' :

3 77/ - 3 $,&,

2. - A&+/' S'/' A

- M&6&* A

N$ 0&$&*&


17/31

CONVULSION

D&: 1 77/ 3 - $,&, &0 0&+'

H/$7'& (@! 7)

C$

D&+0. 1 IV! L 7 BW

%+8* ! *4+&,

A'&0+


18/31

V. CHOLERAE

O1 N$* O1(N$* A77'4+*5'&)

- B$+/& - E'+$0

- C',,

- S&0$+/& - O7%

- I*5

- H$K O2 - 13O1 - 12

O13

B&*7' S+0*


19/31

ENTEROTO9IN

A5,$0+$* $6 N

* V''$4, C&'', 0& *++

S406& R&&+$0

S&0&+$* $6 C'-

* C0/+ C&'',

A&*/' C/',&

C - AMP


20/31

>::

Cy;

B67: Lm+

As6;6+

6+


21/31

V. CHOLERAE

JEJUNUM

- COPIOUS DIARRHOEA

- FISHY RICE WATER STOOLS

- FEVER (-)

- ABDOMINAL PAIN (-)

- RAPID DEHYDRATION > SHOC

- BIOCHEMICAL ()

- HISTOLOGY (-)


22/31

DIAGNOSIS

- CLINIC

CHILDREN < 2 YEARS

SEVERE DEHYDRATION

THE OTHER CHILDREN ()

- LABDAR FIELD MICROSCOPE

CULTURE


23/31

T8 W+&0 > E'&+0$'/+&,R*7&0=,

L++& I.V.

FEEDING

ANTIMICROBIALT&+0/'*& $0

D$//'*&

R&8/0+$* > M*+&**&

F&' S$4

( 11 E L)


24/31

DYSENTERY SINDROME ; BLOODY DIARRHOEA

1. DYSENTERY

- BACILLARY

- AMOEBIC

2. E*+&0$$'+,

- C$%, ' ''&07/

3. T0840,,

. O+8&0, - E*+&0$ *,& E $'

- C. K&K4*


25/31

BACILLARY DYSENTERY

; SHIGELLOSIS

COLON

S. DYSENTERIAE

S. FLE9NERI

S. BOYDII

S. SONNEI


26/31

SHIGELLA

INVASIVE SHIGA TO9IN

INHIBITION OF

PROTEIN SYNTHESIS

CYTOTO9IC


27/31

SHIGELLA

- WATERY DIARRHOEA- BLOODY DIARRHOEA

- TENESMUS

- ABDOMINAL PAIN- URGENCY

- FEVER- CONVULSION

- SEPTIC

-HEMOLYTIC UREMICSYNDROME

- TO9IC MEGA COLON

- RECTAL PROLAPS


28/31

T8

1. WATER > ELECTROLYTES

2. FEEDING

3. - SELF LIMITED - SEVERE TMP - SM9

C&6&:

77/

2 $,&,

*'

,'*


29/31

AL#ONELLOI

TY$HOI"AL ENTERIC E>ER ?

-. TY$HOI" TY$HOI" E>ER

-. $ARATY$HOI" $ARATY$HOI" E>ER

NON TY$HOI"AL ? AL#ONELLA

!ATROENTERITI


30/31

IN"ICATION O ANTI#ICROBIAL

TREAT#ENT IN AL#ONELLA

!ATROENTERITI

3 #ONTH O A!E

2. OL" "EBILITATE" $ATIENT

3. "YENTERY OR# E$ECIALLY

ILLNE @ 5 "AY

4. I##*NOCO#$RO#IE" ? TEROI",

#ALI!NANCY

5. BACTERIAE#IA


31/31

I*6*+ 1 $*+8, $6 7&? %, ++& +$ 8$,+' %+8I*6*+ 1 $*+8, $6 7&? %, ++& +$ 8$,+' %+8

008$&.008$&.O* &*+$*O* &*+$* :: BW ; 7QBW ; 7Q *6*+ %&'' > '&0+Q*6*+ %&'' > '&0+Q

&/&, :&/&, : ,4*&*,4*&* Q 0*, &7&0'/Q ,* *8 7$&,Q 0*, &7&0'/Q ,* *8 7$&,

5:4'/.5:4'/.

4&,+$* :4&,+$* :

1.1.D&8/0+$*..D&8/0+$*..

2.2.A$4*+ $6 6'4, %'' 5& 7&*A$4*+ $6 6'4, %'' 5& 7&*

3.3.I6 +8& 55/ 0&*=+ 5'& +$ 0*? %8+ * $6I6 +8& 55/ 0&*=+ 5'& +$ 0*? %8+ * $6*+&0&*+$* , *&&&*+&0&*+$* , *&&&

.I6 +8& 55/ , 0*, *$0''/? %8+ +/& $6.I6 +8& 55/ , 0*, *$0''/? %8+ +/& $6

&8/0+$*&8/0+$*

E&0,& :

Diarrhoea(Part 2)

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