Diarrhea, controlling

Other Clay Uses. Other appHcations for clays include use as a suspending agent, eg, montmorillonite and attapulgite in Hquid fertilizers and dishwasher detergents in pharmaceuticals (qv), eg, kaoHnite and attapulgite for diarrhea control in cosmetics, montmorillonite and attapulgite and in water impedence where bentonite linings are used for reservoirs and waste disposal areas. 

Non-enteric-coated pancreatic enzyme supplements can be used for initial therapy. The relative dose of amylase, lipase, and protease may be increased until control of pain and fatty diarrhea is achieved or the patient experiences intolerable side effects. If pain and diarrhea control are achieved, the patient can be transitioned to an enteric-coated supplement to maximize compliance. A reasonable example starting regimen is Viokase-8, six tablets with each meal and at bedtime, given with famotidine 20 mg at bedtime. 

Diarrhea is a well-known complication of antibiotic therapy. Rates of antibiotic-associated diarrhea (AAD) vary from 5 to 25%. Some antibiotics are more likely to cause diarrhea than others, specifically, those that are broad spectrum and those that target anaerobic flora. This paper reviews the effects of antibiotics on the fecal flora as well as host factors which contribute to AAD. Clinical features and treatment of AAD are also described. Prevention of AAD rests on wise antibiotic policies, the use of probiotics and prevention of acquisition in the hospital setting. Data from clinical trials suggest that poorly absorbed antimicrobials might have a decreased risk of causing AAD and Clostridium difficile-associated disease, as concluded from studies of antibiotics used for preoperative bowel decontamination and poorly absorbed antibiotics used for traveler s diarrhea. Controlled trials would prove this but are not yet available. Probiotics may be a good adjunct to poorly absorbed antibiotics to minimize the risk of diarrhea associated with antibiotics. 

Animal diarrhea control agents Isobutylene, 1-octadecene Britain 1,260,451 1972 Monsanto... 

The most common adverse reaction associated with phenobarbital is sedation, which can range from mild sleepiness or drowsiness to somnolence. These dru > may also cause nausea, vomiting, constipation, bradycardia, hypoventilation, skin rash, headache fever, and diarrhea Agitation, rather than sedation, may occur in some patients. Some of these adverse effects may be reduced or eliminated as therapy continues. Occasionally, a slight dosage reduction, without reducing the ability of the drug to control the seizures, will reduce or eliminate some of these adverse reactions. 

ANTACIDS. When antacids are given, the nurse keeps a record of the patient s bowel movements because these drug may cause constipation or diarrhea. If the patient experiences diarrhea, the nurse keeps an accurate record of fluid intake and output along with a description of the diarrhea stool. Changing to a different antacid usually alleviates the problem. Diarrhea may be controlled by combining a magnesium antacid with an antacid containing aluminum or calcium. 

Clinical experience with the infants exposed primarily to PCP pre-natally is remarkably close to Wilson et al. These neonates are difficult to console, have alternating periods of lethargy and irritability, and are unable to control the tremors of their extremities when unswaddled. Vasomotor instability, diarrhea, and voracious sucking movements are infrequently seen in the PCP-exposed infants who were followed. Chasnoff et al. (1983) compared these behaviors in infants exposed prenatally to PCP to those of adults who have acute intoxication. 

Misoprostol is a synthetic prostaglandin E2 analog that exogenously replaces prostaglandin stores. The minimum effective dose shown to inhibit acid secretion and promote mucosal defense is 400 meg/day. Misoprostol use is limited by a high frequency of bothersome gastrointestinal effects such as abdominal pain, flatulence, and diarrhea. In placebo-controlled studies diarrhea occurred with twice the frequency in the... 

Monitor for symptom control in patients with chronic diarrhea. 

Antimotility agents should be expected to reduce stool frequency and control diarrhea. 

It will be recalled that a common side effect of morphine is the induction of constipation. This property of the drug has often been exploited in the design of preparations used to control diarrhea. 

The Centers for Disease Control (CDC) in the USA has estimated that Campylobacter and Salmonella are the top two bacterial foodbome pathogens as they are responsible for a total of 2 and 1.3 million foodbome infections every year (Mead et al., 1999). Most of the cases of infection with Campylobacter and Salmonella appear to be due to eggs and poultry, but a significant number of cases are related to beef products (CDC, 2005 Jay, 2000). EHEC does not cause as many infections as the top two pathogens (approximately 100,000 in the USA), but EHEC is frequently linked to outbreaks of diarrhea caused by the consumption of contaminated ground beef (Mead et al., 1999, Rangel et al., 2005). Infections caused by EHEC are the major microbial public health concern related to ruminant food products. 

In the last 20 years, an increased number of enterohemorrhagic diarrhea outbreaks have been caused by highly virulent E. coli strains. EHEC are capable of causing serious complications such as hemolytic uremic syndrome in children and vascular disease in elderly people. E. coli serotype 0157 H7 has been the primary cause of outbreaks of EHEC, but other serotypes such as 026 and Olll are also a major public health concern. The Center for Disease Control has calculated that E. coli 0157 H7 is responsible for more than 70,000 infections and 60 deaths, and other EHEC strains cause approximately 36,000 illnesses and 30 deaths every year in the USA (Mead et al., 1999). In 1994 E. coli 0157 H7 was legally declared an adulterant in ground beef in the USA (USDA/FSIS Directive 10,010.1, 2004). Since then... 

Many of these organisms are easily transmitted through food and water or by human contact. Thus, prevention by avoiding the ingestion of raw or undercooked meat, seafood or unpasteurized milk products, and the selective use of available vaccines are the key to the control of infectious diarrhea. 

In addition to ANP where it is associated with GI dys-motility [198, 199], SIBO is present in a significant proportion of patients with chronic pancreatitis [200, 201], Short-term rifaximin therapy was able to normalize the hydrogen breath test and improve symptoms (i.e. diarrhea and fecal fat excretion) in all patients studied (fig. 9) [201]. Bowel decontamination via administration of this topical antibiotic could, therefore, be beneficial in both acute and chronic pancreatitis. Double-blind, placebo-controlled studies are to be performed to explore the rifaximin potential in this indication. 

Taylor DN, MacKenzie R, Durbin A, Carpenter C, Atzinger CB, Haake R, Bourgeois AL Double-blind, placebo-controlled trial to evaluate the use of rifaximin (200 mg TID) to prevent diarrhea in volunteers challenged with Shigella Jlexneri 2a (2457T). Am J Trop Med Hyg 2004 71(suppl 4) 1-303 (abstract No. 2079). 

Sanfilippo et al. [24] randomized, placebo-controlled, children acute diarrhea rifaximin/control 10/8 E. coli 20 20-40 mg/kg/day (4 days) placebo 17 matched placebo (4 days)... 

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