Lecture 9+10 - Diarrhea.pptx - Non-prescription drugs DIARRH EA Dr Mohammad Majed Al Ahmad PhD BCPS MSc DIP BSc Asst Professor College of Pharmacy Al

Lecture 9+10 - Diarrhea.pptx - Non-prescription drugs...

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Non-prescription drugs DIARRH EA Dr. Mohammad Majed Al Ahmad, PhD, BCPS, MSc, DIP, BSc Asst. Professor College of Pharmacy Al Ain University of Science and Technology
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Introducti on When the contents of the intestines contain too much fluid, or Movement through the GI tract is too rapid Fluids cannot be absorbed and an excessive volume reaches the large intestine This results in sudden initiation of stretch receptors and rapid evacuation of the colon, causing diarrhea.
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Clinical definition Alteration in a normal bowel movement characterized by an increase in the water content, volume, or frequency (more than three times per day) of stool. Diarrhea is usually defined as more than three loose or watery bowel movements per day without any known cause. Often accompanied by gas, cramping, or general abdominal discomfort
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Classifica tion Diarrhea may be acute , persistent , or chronic . Acute diarrhea less than 14 days duration, can generally be managed with fluid and electrolyte replacement, dietary interventions, and nonprescription drug treatment. Persistent diarrhea 14 days to 4 weeks duration. Chronic diarrhea more than 4 weeks. Chronic and persistent diarrheal illnesses are often secondary to other chronic medical conditions or treatments and need medical care
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Pathophysiol ogy May be classified into several major categories related to underlying cause: a. Secretory i. Secondary to enhanced secretion by intestinal mucosa. Often, large, watery volume with loss of electrolytes ii.Common causes: Bacterial or viral or bacterial enteritis, gastric hypersecretion, carcinoid, stimulant laxatives, bile acid malabsorption, celiac disease (gluten-sensitive enteropathy that triggers an immune response), IBD (mucosal)
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Pathophysiol ogy b. Osmotic i. Secondary to a hyperosmolar gradient in the intestinal lumen ii.Common causes: Osmotic laxatives, carbohydrate malabsorption (lactase deficiency), fat malabsorption (pancreatic insufficiency), short bowel syndrome
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Pathophysiol ogy c. Exudative or inflammatory i. Secondary to inflammation or infiltration or invasion of the intestinal mucosa ii.Common causes: IBD, invasive infection ( C. difficile toxin, enterotoxigenic Escherichia coli, cytomegalovirus, Shigella ), ischemic colitis, radiation enterocolitis, neoplasm
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Pathophysiol ogy d. Altered motility or motor i. Secondary to autonomic nerve dysfunction ii.Common causes: Diabetic neuropathy, hyperthyroidism, irritable bowel syndrome (IBS), Addison disease
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Drug-induced diarrhea. May occur by a variety of mechanisms:
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Pathophysiol ogy Food-Induced Diarrhea Lactase enzymatic activity may be reduced in infectious diarrhea. Acute viral diarrhea may cause temporary milk intolerance in patients of all ages. Infants born with lactase deficiency and adults who develop lactase deficiency are intolerant of cow's milk and milk-based products.
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