Understand Safety Issues Around Diarrhoea Before Treating It — Transcript

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1. 0:04we have a number of AIMS in this chapter
2. 0:07but the main drug that we'll be
3. 0:09discussing is loperamide and loperamide
4. 0:13is used for the treatment of diarrhea
5. 0:16and as I said in the last chapter the
6. 0:18first thing that we need to do in order
7. 0:20to understand any medication and be able
8. 0:23to use it safely is to have at least a
9. 0:28general understanding of the disorder
10. 0:30that is being treated especially the
11. 0:33safety issues around that disorder
12. 0:37so right now I want you to think about
13. 0:39the safety issues of diarrhea you may
14. 0:43know or if you don't try to think about
15. 0:46the answer to these questions using the
16. 0:49information that you do know
17. 0:52what are the main complications that you
18. 0:55think can result from diarrhea
19. 0:59what age groups and body shapes are most
20. 1:03susceptible to the complications of
21. 1:06diarrhea and how would you know that the
22. 1:09person needs to be administered to the
23. 1:12emergency room because of these
24. 1:14complications
25. 1:18and you were correct if you identified
26. 1:21dehydration
27. 1:23electrolyte abnormalities and
28. 1:26abnormalities in acid-base regulation of
29. 1:30the body as being the main safety issues
30. 1:33of diarrhea
31. 1:35and think about what's happening in
32. 1:37diarrhea a lot of fluid in electrolytes
33. 1:40in the person's system are being
34. 1:41excreted
35. 1:43normally the kidneys are the organ that
36. 1:45release most of the fluid and the
37. 1:48kidneys have ways of decreasing the
38. 1:50release of the fluid and they also have
39. 1:52ways of adjusting the electrolytes that
40. 1:54are released
41. 1:56that maintains the ideal level of
42. 2:00electrolytes and it also maintains the
43. 2:03correct pH or acid-base levels
44. 2:08but if diarrhea is occurring we don't
45. 2:12have as much control over these
46. 2:15parameters so the person will be losing
47. 2:18a lot of potassium and magnesium in the
48. 2:21stools they'll be excreting a lot of
49. 2:23bicarbonate which is the alkaline
50. 2:26molecule in the body that keeps our
51. 2:28blood from getting too acidic and any
52. 2:31significant abnormalities in any of
53. 2:35these can result in convulsions and
54. 2:39other neurologic symptoms coma and
55. 2:41possibly even death especially in
56. 2:44susceptible people so the next question
57. 2:47is who are the people who are most prone
58. 2:50to dehydration well the very young and
59. 2:54the Very Old so infants are extremely
60. 2:58prone to dehydration and also respond to
61. 3:02a much smaller variation in the
62. 3:05imbalances of the electrolytes with the
63. 3:08emulsions that could cause brain damage
64. 3:11or death of the infant
65. 3:13also important to note is the fact that
66. 3:16obese individuals will experience
67. 3:18dehydration much more quickly than
68. 3:20non-obese individuals of the same age
69. 3:23and that's because adipose tissue or fat
70. 3:26tissue has only about 10 percent water
71. 3:30content while the rest of the tissues in
72. 3:34the body average around 70 percent water
73. 3:38content
74. 3:39the way to determine dehydration is to
75. 3:42look for these signs and symptoms
76. 3:44including dry mouth very concentrated
77. 3:48dark urine excessive thirst and a
78. 3:53decrease what we call skin turgor which
79. 3:56can be tested by pinching the skin on
80. 3:59the back of the hand and seeing how
81. 4:01quickly it Springs back to the original
82. 4:04position a person whose dehydrated will
83. 4:08have a decreased skin turgor or in other
84. 4:12words the spring back to the original
85. 4:15position will be decreased
86. 4:18but one important thing about testing
87. 4:21skin turgor you've got to realize that
88. 4:23there's going to be less spring back in
89. 4:26a very elderly person so you need to
90. 4:29take that into consideration as well and
91. 4:32now that you understand what the most
92. 4:34important complication of diarrhea is
93. 4:37I'd like you to predict the answer to
94. 4:40this question
95. 4:42what do you think that the primary
96. 4:44therapy for diarrhea would be
97. 4:48and you are correct if you said that the
98. 4:51primary therapy for diarrhea is to make
99. 4:55sure the person is drinking plenty of
100. 4:57fluids and having some oral rehydration
101. 5:01drinks
102. 5:03other therapies can be considered only
103. 5:06after we've made sure that the person is
104. 5:09not in danger of being dehydrated