Treatment of Diarrhea for Infants and Adult

Diarrhea is a disease that cause by toxins, microorganisms and other substances, which do not usually occur common in the gastrointestinal tract (GIT). These foreign agents and organisms are causing the GIT to react violently, through faster peristalsis, to either eliminate them or purge them. 

When the substance or organism is too many to eliminate diarrhea will be prolonged and dehydration will be the consequence. Also when a patient has diarrhea regular eating habit will not meet and the body will be deprived from nutrients and energy coming from food. Thus, treatment should be given to avoid dehydration, weakness, vomiting and worst death.

First Line Treatment:

1. Oral Rehydration Solution (ORS) – This is the first and foremost supportive treatment when diarrhea occurs. Either infant or adult is the victim ORS must not be abandoned as the first line supportive treatment, because it rehydrates the body with balanced and proper electrolytes, energy and fluids. ORS comes with the combination of sodium, chloride, potassium, and citrate (bicarbonate in some formula) electrolytes for cellular function to continue, including glucose for source of energy and purified water for hydration. Oral Rehydration Solution will be given during the course of the diarrhea. As long as diarrhea is there ORS should also present, unless the patient is brought to hospital where intravenous fluids are given to him/her.

Examples of brands of ORS:

• Pedialyte Mild 30 and other variance and flavor. 
• Glucolyte 
• Other generic ORS
• Hydrite
• Gatorade (Note: It is not advisable to use it as rehydration solution alone!  It should be still combined with the above ORS products.)

2. Loperamide and other gastrokinetic drugs  – Loperamide is used to reduce the movement of the intestines during loss bowel movement. Because of this effect, sometimes Loperamide is not advisable to use, because it impedes the elimination of toxins or microorganisms that causing the diarrhea. It is advisable to use when muscle cramps or spasms occur to pacify the pain in the GI muscles. Hyoscine is also used for spasms or cramps. When vomiting is occurring metoclopramide is given to stop the puking. Hyoscine and metoclopramide must be given with prescription order through oral (at home) or IV in hospital. Sometimes dicycloverine is given but it depends on the doctor’s order. Loperamide can be procured in pharmacy over-the-counter. Ask the pharmacist regarding the use of it.

Example of brands:

• Loperamide – Imodium, Lomotil, Diatabs and so on.
• Hyoscine (HNBB) – Buscopan
• Metoclopramide - Plasil 

3. Antisecretory agent and Probiotics – Antisecretory agent such as Racecadotril which can prevent the secretion of fluids in the GIT that adds more to the fluidity of the diarrhea. When this drug is administered it will stop the site of production of fluids in the intestines. Probiotics can help to rebalance the normal bacterial flora in the intestines. Microorganisms will absolutely purge also when diarrhea occurs, which reduces their number in the tract or especially when antibiotic treatment is administered. Good bacteria keep the GIT balanced by fighting the bad bacteria, and neutralizing the toxins and some substances that preventing the normal function of the GI system. Remember to take these drugs with proper physician’s order.

Example of Brands:

• Racecadotril  (Antisecretory agent) – Hidrasec 
• Bacillus clausii (Probiotic) – Erceflora 

4. Antibacterial Prescription Drugs – Such as Metronidazole and Cotrimoxazole. These drugs can be given when bacteria are the main cause of the diarrhea. There are more antibacterial drugs that can be prescribed but these are the common ones.

Conclusion:

Diarrhea is a serious case disease that when left untreated it will lead to death. There are many types of it, in which it depends on the causative agent. When diarrhea occurs supportive treatment should be given only at home. However, when diarrhea does not stop within 12 - 24 hours from its commencement the patient should be brought to hospital for proper treatment and IV fluids to be administered. Especially when vomiting is occurred do not hesitate to bring him/her in the hospital or clinic. Do not self-diagnose or  self-medicate. Follow the emergency treatment in which if the treatment is not effective visit a physician or bring the patient to the nearest hospital.

Tempra or Biogesic or Calpol: What is the best paracetamol for children?

Whenever a child's temperature is up fever medicines are always there to lower it. Paracetamol (Acetaminophen in other places) is best and well-known to lower fever at any age. For whatever causes the fever it can regulate it. Either in hospital use or home use paracetamol is always available in different forms, such as suspension or syrup, suppository, intravenous, tablets or capsules, which depend on the need or condition of the patient.

In children's conditions who cannot yet much express their feeling it is very hard to give them medicines, especially paracetamol for fever, because of its bitter taste. So, it is absolutely needed that the paracetamol you choose for your child should have a sweet taste and enticing flavor to allow children to voluntarily take the medicine with ease. Also when choosing a paracetamol for your child, it should be cost-effective and can lower the fever immediately and regulate the fever within the stated optimum effect.

Tempra or Biogesic or Calpol: What is the best paracetamol for children?

1. For me they are all square when it comes to effect, because of course they have the same generic name which is paracetamol. But the difference lies on the dosage form, which is very important to know. Suspension paracetamol needs to be shaken first before taken, so that the drug will be distributed equally in the liquid vehicle. However, syrup paracetamol is a well-distributed dosage form that does not need agitation to disperse the drug equally to the vehicle. In short it is ready to take paracetamol medicine. Another thing to be added is that the syrup has the higher absorption rate than that of suspension. Because the syrup does not need to disintegrate into the tiniest particle before it can be absorbed, instead, it is in the micronized particle already that can be ready to be absorbed in the gastrointestinal tract, but, in contrary, suspension is needed to disintegrate first before absorption occurs.   Therefore, Tempra which is syrup in form has the fastest absorption rate based on their dosage form.

2. The taste of the three products are not questionable as to the three brands have favorable taste and flavors to choose from.

3. Recommendation of age use. I think the best brand  recommendation of age use  is the Calpol that entails the oral drops (100mg) is  for 0 - 2 years old; 120mg (125mg in some paracetamol brand) is for 2 - 6 years old; and 250mg is for 6 - 12 and above. But dosage may change depends on the BMI, weight, age and condition of the patient.

4. Information of the drug. All the three brands have showcased the important information about paracetamol, including use, effect, precautions, side-effects and etc.

5. Price. Price is one of the basis for parents to choose a paracetamol brand. As we know Tempra is the costliest among the three, followed by Calpol and the cheapest is the Biogesic brand. But of course, the use and immediate action will always consider too! Moreover, when a parent is deciding for a cost-effective brand, does Biogesic will be chosen.


Summary of the Brands:

Brand	Dosage Form	Taste and variety of flavor	Age of Use	Information	Price
Biogesic	Better	Better	Better	Better	Best
Calpol	Better	Better	Best	Better	Better
Tempra	Best	Better	Better	Better	Good

Note: This article is based only to the knowledge of the author about paracetamol and its brands. The author does not recommend any brand/s to the readers, instead, information sharing only.