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ing heart and kidneys, which will retain what is needed and excrete the rest. Furthermore,
diarrheal salt losses vary more than such measures. Disinfected water must be used to dis-
solve the salts and glucose. Individuals with moderate diarrhea (five to ten watery stools
per day) should drink one to three liters of solution in addition to their usual water intake
every twenty-four hours. Persons with more severe diarrhea (ten or more watery stools per
day) should drink enough solution to equal the volume of the estimated losses and an ad-
ditional 1.5 to 2 liters per day. No salt-free water should be consumed until rehydration is
achieved and the diarrhea is substantially improved.
Table 19-1
Oral Fluid Replacement Solutions
3.5 gm per liter or
½ level teaspoon per liter
Sodium chloride
2.5 gm per liter or
½ level teaspoon per liter
Sodium bicarbonate
1.5 gm per liter or
¼ level teaspoon per liter
Potassium chloride
20 gm per liter or
6 level teaspoons per liter
Glucose
or
40 gm per liter or
12 level teaspoons per liter
U.S. PUBLIC HEALTH SERVICE FORMULA (CENTERS FOR DISEASE CONTROL AND
PREVENTION)
Sucrose (table sugar)
Glass no. 1
8 ounces fruit juice
½ teaspoon honey or corn syrup
1 pinch table salt
Glass no. 2
½ teaspoon baking soda (bicarbonate)
8 ounces water (disinfected)
Drink equal amounts from each glass, alternating between the two.
Treatment of nausea and vomiting with orally dissolving ondansetron tablets (Zofran
ODT®),oralprochlorperazine(Compazine®),orprochlorperazineorpromethazine(Phen-
ergan®)suppositoriesmayberequiredforadequateamountsoforalfluidstobeconsumed.
Bismuth subsalicylate (Pepto-Bismol®), two tablets every six hours, may also be helpful.
Whether drugs that specifically control diarrhea should be used is controversial. Some
evidencesuggeststheseagentsmayprolongtheillnesseventhoughthefrequencyofbowel
movements is decreased. A compromise that appears reasonable is to administer medica-
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