IBS Tx Flashcards
What is IBS
idiopathic chronic disorder with abdominal discomfort, pain, bloating, distention or cramps in association with diarrhea, constipation or both
goals therapy IBS
relieve abdominal pain and discomfort and improve bowel function
what are the important first steps in management of IBS
patient counseling and dietary change
what is used for IBS with predominant diarrhea
loperamide
Tx for IBS predominant constipation
osmotic laxatives
what is used to Tx chronic abdominal pain in IBS patients
low dose tricyclic antidepressants like amitryptyline
what is the prototype for a serotonin partial agonist
tegaserod
available in restricted program form increase risk in ischemic events
what is the prototype of 5-HT3 R antagonist
alosetron- restricted use program
what are the other serotonin antagonists on market
ondansetron, granisetron, dolasetron, palonosetron
MOA serotonin antagonists
inhibits GI afferent R reducing unpleasant sensations
blocks central R reducing visceral afferent stimulation– inhibits colonic motility, increasing transit time
therapeutic use serotonin antagonists
women with severe diarrhea from IBS
efficacy in men not established
reduces lower abdominal pain,c ramps, urgency, diarrhea, decreases mean number bowel movements per day and improves stool consistency
adverse effects to serotonin antagonists
constipation
Drug interactions wiht serotonin antagonists
none
MOA antispasmotics used in IBS and what are drug names
dicyclomine and hyoscyamine
inhibit muscarininc cholinergic R in enteric plexus on smooth muscle
high does- excessive anticholinergic effects
What is prototype chloride channel activator in IBS
lubiprostone
