q: why are drugs used to treat connective tissue diseases not used to treat immunosuppressive diseases?
a: connective tissue diseases are treated with immunosuppressive drugs and nsaids. you wouldn't give immunosuppressants to an already-immunocompromised patient (such as hiv) or they will have an even greater risk of opportunistic infection, and the manifestations of infection would be masked.
does that look right? also, why not nsaids? might it have something to do with the bleeding in the stomach?
Specializes in med/surg, telemetry, IV therapy, mgmt.
The diarrhea is initiated by osmotic processes. If this were the only problem, the diarrhea could be successfully treated.
It is the physical barrier of the candida proliferation blocking the semipermiable membrane of the intestinal mucosa, preventing the reabsorption of water via the large intestine- that causes diarrhea to become intractable in AIDS pts.
Intractable diarrhea should be treate with Nytstatin- treatement with only anti-diarrheals and/or anticolinergics is not effective.
My information is from a handout I received from a hospice physician's inservice.
Correct. Diarrhea is the resulting problem (thus, the diagnosis). The bug is one of the underlying causes that trigger it.
Specializes in med/surg, telemetry, IV therapy, mgmt.
Yes, I understand. Increased motility or osmotic diarrhea. It doesn't quite fit my theory about the bleeding in the stomach allowing a port of entry for the bacteria though, since it is happening further down in the GI tract. I am thinking it has more to do with the loss of clotting factors and perhaps the further suppression of the inflammatory system.
Thanks for helping me think this through.
The problem is that the pH of the stomach is so acidic that few organisms can thrive there. They have better luck lower down. This is why viruses are more successful. Hard to kill off those suckers because of the way they work and replicate.
I was thinking of how septicemia occurs. Bacteria lodged in the tissues where inflammation is already occurring enter the blood stream because of the vascular permeability produced by the inflammation response. Because of the vascular permeability, bacteria that are already invading an area are able to escape into the blood stream and begin traveling to other parts of the body. Once this bacteria enters the blood stream they release endotoxins and the symptoms of bacteremia are produced.
Daytonite, BSN, RN
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Correct. Diarrhea is the resulting problem (thus, the diagnosis). The bug is one of the underlying causes that trigger it.