Diarrhoea and constipation medicine

Question 1

Naloxegol (Moventig)

Answer 1

used in opioid induced constipation, u receptor antagonist. Binds to opioid receptors in the myenteric and submucosal plexuses. Blocks adverse action on motility/secretion. Does not cross the blood brain barrier,

Question 2

Enterokinetics such as Plucalopride (Resolor)

Answer 2

management of chronic constipation,

Promotes motility and mucosal secretion, binds 5Ht4 receptors and increase Ach

Question 3

Lubiprostone (Amitiza)

Answer 3

Cl- channel activators, it increases the luminal secretion of Cl- and fluid leading to increased peristalsis

Question 4

Diarrhoea treatment,

Answer 4

Oral rehydration solutions; prevents dehydration eg. Diorylate
Anti motility drugs: increase bowel tone and delay intestinal transit time eg. loperamide
Anti secretory drugs: agents which reduce secretion eg. bismuth subsalicylate

Question 5

Opioid agonist in the treatment of diarrhoea

Answer 5

i.e. Loperamide (imodium)

inhibits intestinal motility.

Question 6

Anti secretory agents in the treatment of diarrhoea

Answer 6

Racecadotril (Hidrasec); prodrug, blocks the degradation of endogenous opioids, decreases intestinal hypersecretion of fluid and electroylate