Diarrhea (OTC Treatment)

DIARRHEA Diarrhea = an increase in stool frequency Loose, watery stools May be acute or chronic Viruses are the cause of most acute diarrhea  (rotavirus vaccine cures this the majority of the time) Traveler’s diarrhea is usually bacterial in nature May also be caused by parasites, food intolerances (lactose), medications (like antibiotics) Lactose intolerance:  congenital … Continue reading

Acid Related Disorders (OTC Treatment)

Acid Related Disorders Peptic Ulcer Disease (PUD) Disruption of the upper GI lining (mucosa) that must be diagnosed by a physician Characterized by possible blood in vomit or stool (GI bleeding) Usually caused by bacteria Treated w/ H2 antagonists & antacids Heartburn Burning, pain in esophagus (upper GI as opposed to peptic ulcer which is … Continue reading

Acid/Base Disorder Overview

Anion gap helps determine the existence and cause of metabolic acidosis Anion gap (AG) = [Na] – ([Cl-] + [HCO3-]) Normal = 10-12 mEq/L Alkalemia Respiratory alkalosis if CO2 < 40 Metabolic alkalosis is HCO3 > 25 Acidemia Respiratory acidosis if CO2 > 40 Metabolic acidosis if HCO3 < 25

Metabolic Acidosis

Increased anion gap metabolic acidosis Anion Gap Metabolic acidosis  (gap > 10-12 mEq/L) Signs/symptoms:  hyperventilation, N/V, hyperkalemia, hypotension, cardiac arrhythmias, lethargy, coma Causes:  renal failure, ketoacidosis (diabetes, alcoholism, starvation), lactic acidosis (anemia, CO poisoning, shock), drug intoxication (methanol, ethylene glycol, salicylates, paraldehyde) Methanol Uremia Diabetic ketoacidosis/starvation or EtOH ketoacidosis Poisoning Isoniazid/Intoxication/Infection Lactic acidosis Ethylene glycol/EtOH … Continue reading

Metabolic Alkalosis

Saline-responsive metabolic alkalosis  (urine Cl < 10 mMol/L) Metabolic alkalosis: Signs/symptoms:  muscle cramps, tetany, hyperreflexia, seizures, hypercapnia (increased pCO2), decreased serum & urine chloride concentrations, hypokalemia/hypocalcemia, mental confusion, increased susceptibility to tachyarrhythmias, increased risk of digoxin toxicity Causes: Contraction (diuretics cause loss of volume—pull out chloride, bicarb accumulates) Licorice* Endo (Cushing’s*) Vomiting Excess alkali* Refeeding … Continue reading

Respiratory Acidosis

Respiratory acidosis  (primary hypercapnia) Increase in pCO2 Common in patients w/ COPD Signs/symptoms: dyspnea (SOB), flushing, HA, confusion/disorientation, hallucinations, seizures, tachycardia, arrhythmias, increased risk of digoxin toxicity Causes: COPD, CNS disturbances, cardiopulmonary disorders, neuromuscular disorders, aggressive O2 therapy, inadequate mechanical ventilation Response: Acute: intracellular buffering, HCO3- increases 1 mEq/L [from 24] for every 10 mmHg … Continue reading

Respiratory Alkalosis

Respiratory alkalosis  (primary hypocapnia) Decrease in pCO2 Signs/symptoms: increased rate & depth or breaths, lightheadedness, syncope, cramps, muscle spasms, confusion, decreased mental acuity, seizures, tachycardia, arrhythmias, increased episodes of angina Causes:  liver or pulmonary disease, CHAMPS CNS disease  (infection, trauma, tumor, CVA) Hypoxia (high altitude, hypotension, CHF) Hyperventilation due to the following can cause hypoxia:  … Continue reading