Constipation

Question 1

definition

Answer 1

<3 BMs a week but depends on baseline

Question 2

causes

Answer 2

dec fiber diet
comorbidities (IBS, DM, hypothyroid, neurologic injuries, preggo)
meds (OPIOIDS, antihistamines, TCAs, anti-parkinsons, iron, CCBs)

Question 3

treatment options

Answer 3

osmotics (PEG 3350, lactulose but its sickeningly sweet bleh)
opioid receptor antagonists (methylnaltrexone, naloxegal, naldemidine)

Question 4

lactulose uses

Answer 4

constipation

hepatic encephalopathy w cirrhosis

Question 5

opioid receptor antagonists

dosage forms

Answer 5

methylnaltrexone SQ
naloxegal (Movantik) po *needs renal dose adjustment
naldemidine (Symproic) PO , newer

Question 6

chronic idiopathic constipation
tx options and dose

and can also be used for______

Answer 6

Lubipristone (Amitiza) 24 mg po bid
Linaclotide (Linzess) 145 mcg po qd then 72 mcg prn
plecanatide (Trulance) 3mg po qd

IBS-C too!