WHO-ORS Formula Quiz
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Questions and Answers

What is the concentration of NaCl in the new WHO-ORS formula?

  • 2.6 g (correct)
  • 3.5 g
  • 20.0 g
  • 1.5 g

Which compound is used in WHO-ORS instead of bicarbonate for improved stability?

  • Potassium chloride
  • Glucose
  • Citrate (correct)
  • Sodium bicarbonate

What is the total osmolarity of the WHO-ORS formula?

  • 245 mmol/L (correct)
  • 110 mmol/L
  • 75 mmol/L
  • 310 mmol/L

What is the purpose of using a lower osmolarity in the new ORS formulation?

<p>To lower the incidence of vomiting and stool volume (D)</p> Signup and view all the answers

How can a homemade ORS solution be prepared?

<p>Mix 1 liter of boiled water with 8 teaspoons of sugar and 1 teaspoon of salt (D)</p> Signup and view all the answers

What is one of the primary side effects of long-term mineral oil use?

<p>Decreased absorption of fat-soluble vitamins (C)</p> Signup and view all the answers

Which class of stimulants directly affects enterocytes and enteric neurons?

<p>Stimulant purgatives (D)</p> Signup and view all the answers

What is the primary active component released by castor oil in the gut?

<p>Ricinoleic acid (B)</p> Signup and view all the answers

Which anthraquinone derivative is no longer in use?

<p>Aloe vera (A), Cascara sagrada (D)</p> Signup and view all the answers

What mechanism does Lubiprostone utilize to aid gastrointestinal function?

<p>Opening chloride channels in the gut (C)</p> Signup and view all the answers

What consequence can result from the absorption of mineral oil in the body?

<p>Foreign body reactions in tissues (B)</p> Signup and view all the answers

Which substance has been withdrawn from the market due to safety concerns?

<p>Phenolphthalein (D)</p> Signup and view all the answers

Alvimopan acts as an antagonist to which type of receptor?

<p>Mu-opioid receptors (C)</p> Signup and view all the answers

What defines acute diarrhoea according to the duration of symptoms?

<p>Symptoms lasting 14 days or less (B)</p> Signup and view all the answers

Which of the following is NOT a cause of diarrhoea?

<p>Insufficient fiber intake (B)</p> Signup and view all the answers

Which treatment is recommended for managing acute diarrhoea?

<p>Fluid and electrolyte replacement (D)</p> Signup and view all the answers

What type of diarrhoea results from the rapid transit and decreased fluid absorption in the intestine?

<p>Altered motility diarrhoea (C)</p> Signup and view all the answers

Methylnaltrexone is primarily indicated for which condition?

<p>Opioid-induced constipation (B)</p> Signup and view all the answers

What is the primary mechanism by which bulk-forming laxatives promote defecation?

<p>They increase the bulk of stool, stimulating normal peristalsis. (A)</p> Signup and view all the answers

Which statement about methylnaltrexone is accurate?

<p>It does not affect the analgesic effects of opioids (A)</p> Signup and view all the answers

Which of the following are classified as osmotic purgatives?

<p>Lactulose and polyethylene glycol (C)</p> Signup and view all the answers

What is a common characteristic of diarrhoea as defined by WHO?

<p>Three or more loose or watery stools in 24 hours (A)</p> Signup and view all the answers

What percentage of dietary fiber does bran typically contain?

<blockquote> <p>40% (D)</p> </blockquote> Signup and view all the answers

Which of the following side effects is commonly associated with bulk-forming laxatives?

<p>Flatulence and cramps (C)</p> Signup and view all the answers

What is the primary use of octreotide in clinical settings?

<p>To manage severe secretory diarrhea (A)</p> Signup and view all the answers

Which is NOT a class of antidiarrhoeal drugs?

<p>Analgesic agents (B)</p> Signup and view all the answers

Which hormone secretion is NOT inhibited by octreotide?

<p>Epinephrine (B)</p> Signup and view all the answers

What type of laxative includes agents like methylnaltrexone and alvimopan?

<p>Opioid receptor antagonists (A)</p> Signup and view all the answers

How long may bulk-forming laxatives take to have a full effect?

<p>2-3 days (A)</p> Signup and view all the answers

What is a key feature of loperamide as an antidiarrheal agent?

<p>It has a rapid onset of action (D)</p> Signup and view all the answers

Why are diphenoxylate and difenoxin combined with atropine sulfate?

<p>To minimize potential addiction and abuse (D)</p> Signup and view all the answers

Which dietary sources typically provide the highest fiber content?

<p>Fruits, vegetables, and cereals (D)</p> Signup and view all the answers

How do antiperistaltic agents like loperamide affect intestinal function?

<p>They increase the time for water absorption (B)</p> Signup and view all the answers

What is the primary characteristic of saline purgatives?

<p>They create an osmotic gradient to pull water. (D)</p> Signup and view all the answers

What determines the maximum daily dose for loperamide in adults?

<p>Frequency of loose stools (C)</p> Signup and view all the answers

Which of the following conditions can octreotide be used to treat?

<p>AIDS-associated diarrhea (B)</p> Signup and view all the answers

What is the role of probiotics in gastrointestinal health?

<p>To replace colonic microflora (A)</p> Signup and view all the answers

What is the primary treatment goal during episodes of severe diarrhea?

<p>Preventing dehydration (B)</p> Signup and view all the answers

Which of the following agents acts as an antisecretory agent in diarrhea treatment?

<p>Bismuth subsalicylate (B)</p> Signup and view all the answers

What should be avoided when taking oatmeal and pectin-based medications?

<p>Medications taken within 2-3 hours (D)</p> Signup and view all the answers

What is an important precaution for using bismuth subsalicylate?

<p>It may cause darkened stools and tongue. (D)</p> Signup and view all the answers

Which of the following is NOT a reason for patients to use oral rehydration therapy (ORT)?

<p>To provide a high calorie diet (B)</p> Signup and view all the answers

In severe cases of diarrhea, what may be required for replacing large fluid losses?

<p>Intravenous fluids (A)</p> Signup and view all the answers

Which mechanism contributes to the antidiarrheal action of bismuth subsalicylate?

<p>Stimulation of fluid absorption across the intestinal wall (A)</p> Signup and view all the answers

What type of agents are classified as bulk-forming and hydroscopic agents?

<p>Calcium polycarbophil and carboxymethylcellulose (C)</p> Signup and view all the answers

Flashcards

Bulk Forming Laxatives

These laxatives are indigestible fibers and colloids that absorb water, swell the stool, and stimulate peristalsis.

Dietary Fiber

The part of plant matter that our body can't digest, adding bulk to our stool.

Bran

The residue left after making flour, rich in fiber.

Psyllium

A hydrophilic colloid that absorbs water and swells in the colon, adding bulk to the stool.

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Osmotic Purgatives

These laxatives work by creating an osmotic gradient, pulling water into the intestines to soften and increase stool bulk.

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Saline Purgatives

A type of osmotic purgative that uses salts like magnesium sulfate or magnesium hydroxide to draw water.

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Non-Digestible Sugars

Examples include lactulose, sorbitol, and mannitol. They are not absorbed by the gut and draw water into the intestines.

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Polyethylene Glycol

A common type of osmotic laxative that pulls water into the intestine, softening the stool.

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Methylnaltrexone

A medication used to treat opioid-induced constipation. It blocks opioid receptors in the gut without affecting pain relief.

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Opioid-Induced Constipation

A common side effect of opioid medications where the bowel movements become infrequent and difficult to pass.

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Blood-Brain Barrier

A protective barrier that prevents most substances from entering the brain.

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Diarrhea

Frequent passage of loose or watery stools. Usually defined as 3 or more loose stools in 24 hours.

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Osmotic Diarrhea

Occurs when too much water stays in the intestines due to a high concentration of solutes.

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Secretory Diarrhea

Caused by excessive secretion of fluids and electrolytes into the intestines.

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Exudative Diarrhea

Arises from inflammation and damage to the intestinal lining, leading to protein and fluid leakage.

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Antidiarrheal Drugs

Medications used to manage diarrhea. They work by absorbing excess water, blocking secretion, slowing down gut movement, or restoring gut bacteria.

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Mineral Oil Side Effects

Long-term use of mineral oil can decrease absorption of fat-soluble vitamins (A, D, E, K), potentially leading to deficiencies. It can also be absorbed systemically, causing foreign body reactions in the body. Leaking from the anus can also cause soiling.

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Stimulant Purgatives

These laxatives directly impact the gut's lining, neurons, and muscles causing increased intestinal movement and fluid secretion. They work by irritating the intestinal tract.

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Anthraquinone Derivatives

These derivatives are found in plants like Cascara sagrada, senna, and aloe. They are broken down by bacteria in the colon, stimulating increased intestinal movement.

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Castor Oil

Derived from castor plants, castor oil is broken down into ricinoleic acid, a strong irritant that increases fluid secretion and bowel movement in the small intestine.

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Diphenylmethane Derivatives

These derivatives, like bisacodyl and sodium picosulfate, are broken down by bacteria in the colon and irritate the intestinal lining, leading to increased secretion and movement.

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Lubiprostone

A new drug that acts locally in the gut to open chloride channels, increasing fluid secretion and softening the stool, which accelerates bowel movements.

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Opioid-Receptor Antagonists

These drugs, like alvimopan, specifically block the effects of opioids in the gastrointestinal tract, preventing constipation caused by opioid medications.

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What are the effects of Stimulant Purgatives?

Stimulant purgatives directly influence enterocytes, enteric neurons, and GI smooth muscle. They boost intestinal motility and increase water and electrolyte secretion from the mucosa.

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Oral Rehydration Therapy (ORT)

A fluid replacement strategy used to prevent or treat dehydration caused by diarrhea. It's the primary treatment until the diarrhea episode ends.

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Antisecretory Agents

Medications that reduce the secretion of fluids and electrolytes in the intestines, helping to control diarrhea.

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Bismuth Subsalicylate

A common antidiarrheal medication that works in multiple ways: reduces fluid secretion, fights inflammation, and has antimicrobial effects.

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Bulk-forming Agents

Medications that absorb water in the intestines and increase stool bulk, helpful for both diarrhea and constipation.

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Attapulgite, Kaolin, Pectin

These agents bind water and may adsorb nutrients, toxins, and drugs. Their action is not specific and they should be avoided within 2-3 hours of taking other medication.

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Parenteral Solutions

Fluids given directly into the bloodstream, like Ringer's lactate or normal saline, used for severe dehydration.

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WHO-ORS

A specific formulation of Oral Rehydration Solution (ORS) developed by the World Health Organization (WHO). It contains less sodium and glucose than standard ORS, resulting in a lower osmolarity.

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Lower Osmolarity in WHO-ORS

WHO-ORS has a lower total osmolarity compared to standard ORS because it contains less sodium and glucose. This lower concentration is designed to improve its effectiveness in rehydrating individuals with diarrhea.

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Benefits of Lower Osmolarity in WHO-ORS

The lower osmolarity of WHO-ORS leads to improved efficacy, reducing vomiting and stool volume. It improves the absorption of glucose and minimizes stool output.

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Citrate in WHO-ORS

Citrate replaces bicarbonate in WHO-ORS because it makes the solution more stable, enhances glucose absorption, and contributes to a lower stool volume.

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Universality of WHO-ORS

WHO-ORS is suitable for all age groups and all causes of diarrhea. It's safe and effective for rehydration.

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Octreotide

A synthetic drug that mimics somatostatin, effectively inhibiting severe diarrhea caused by hormone-secreting tumors in the pancreas and GI tract. It works by reducing hormone secretions like gastrin, glucagon, and growth hormone, as well as decreasing fluid secretion from the intestine and pancreas.

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Antiperistaltic Agents

Drugs that slow down the movement of food through the intestines (peristalsis), helping to reduce diarrhea by increasing the time for water absorption.

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Loperamide (Imodium)

An orally active antidiarrheal medication that works by slowing down intestinal movement and increasing absorption of water. It has a rapid onset of action and is commonly used for diarrhea.

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Diphenoxylate and Difenoxin

Antidiarrheal drugs that work similar to Loperamide, but are absorbed more quickly and can cause CNS effects at higher doses. They're often combined with atropine to discourage abuse.

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Probiotics

Living microorganisms that are beneficial for the gut. They replenish the healthy bacteria in your gut, helping to restore normal intestinal function and fight off harmful bacteria.

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