IBS-C

Question 1

IBS-C treatment options

Answer 1

Lubiprostone (Amitiza)
Linaclotide (Linzess) and Precanatide (Trulance)
Tegaserol (Zelnorm)

Question 2

first line

Answer 2

Linaclotide (Linzess) and Precanatide (Trulance)

secretagogues/guanalate cyclase R antags

Question 3

Amitiza (lubiprostone) moa use dose AE

Answer 3

activates chloride channels on epithelium of intestines, inc Cl- secretion–> inc motility
for WOMEN w IBS-C
8mg BID WITH FOOD
AE: D/N 8-20%

Question 4

Linaclotide (Linzess) MOA dose AE

first or second line

Answer 4

inc chloride and bicarb secretion
290mg qd po
diarrhea!
first line

Question 5

Precanatide (Trulance) MOA sose AE

first or second line

Answer 5

inc chloride and bicarb secretion
3mg po qd
diarrhea (less than linzess tho)
first line

Question 6

Tegaserol (Zelnorm)
first or second line
MOA

Answer 6

second

5HT4 agonist, inc GI secretions and motility, dec visceral pain

Question 7

Tegaserol (Zelnorm) AE

Answer 7

cardiac events (pulled temporarily from market)

Question 8

Tegaserol (Zelnorm) use

when to D/C

Answer 8

women
<65 yo
no cardiac hx
no more than 1 cardiac RF (HTN, smoker, BMI >30, DM, HLD, >55yo)

D/C if no benefit within 4-6 weeks