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Pharm II Exam 4 > Treatment of IBS > Flashcards

Flashcards in Treatment of IBS Deck (25):
1

What are pharmacologic therapies directed at?

relieving abd pain & discomfort & improving bowel function

2

What is the MOA of 5-HT?

Secretion, sensitization, & motility

3

What is the MOA of linaclotide?

Guanlyate cyclase-c agonist

Stimulates intestinal fluid secretion & transit time

4

What does linaclotide improve?

abd pain/discomfort

5

What is an ADE of tegaserod (Serotonin 5-HT4 receptor agonist) ?

Increased # of CV deaths

Removed from market except in the emergency situation

6

What is the MOA of loperamide?

Treats IBS-D

Inhibits peristalsis, prolongs transit time, & reduces fecal volume

7

What sx are NOT relieved by loperamide?

bloating, abd discomfort

8

What are the dosing instructions for loperamide?

2mg 45 mins before a meal on regularly scheduled doses

9

What is the MOA of eluxadoline?

Mixed mu-opioid receptor agonist, delta-opioid receptor antagonist & kappa opioid receptor agonist

Reduces abd pain & diarrhea

10

What is 2nd line therapy for IBS-D?

Bile acid sequestrants

11

What are ADEs of bile acid sequestrants?

GI sx: bloating, flatulence, abd discomfort, constipation

12

What is the MOA of 5-HT3 receptor antagonists?

Reduce unpleasant visceral afferent sensation, including nausea, bloating, & pain

Inhibits colonic motility, esp in the left colon, increasing total colonic transit time

13

Alosetron (a 5-HT3 receptor antagonist) has been approved for what population?

Women w/ severe IBS-D who have not responded to conventional therapy

*Requires FDA-approved restricted-use program

14

Describe the efficacy of alosetron

Reduces abd pain, cramping, urgency, & diarrhea

15

What is an ADEs of alosetron?

Constipation (30%)
Ischmic colitis (3/1000 pts, some fatal)

16

Describe the pharmacotherapy of chronic abd pain

TCAs appear helpful

Alter processing of visceral afferent info

Anticholinergic properties

Alter receptors for enteric NTs s/a serotonin

17

Name 2 antispasmodics (anticholinergics) that are used in IBS

Dicyclomine
Hyoscyamine

18

What are ADEs of antispasmodics (anticholinergics)?

Higher doses --> Dry mouth, visual disturbances, urinary retention, & constipation

19

What are possible causes of IBS?

Visceral hypersensitivity
Altered bowel motility
NT imbalance
Infection
Psychosocial

20

IBS treatment usually consists of low FODMAP diet. What does FODMAP stand for?

Fermentable
Oligosaccharides
Disaccharides
Monosaccharides
And
Polyols

21

What are the 2 types of 5-HT that exist within the gut?

Serotonin type 3 & 4

22

What is the MOA of serotonin 5-HT4 receptor agonists (tegaserod)?

Stimulates release of NTs & increases colonic motility

23

What is eluxadoline contraindicated in?

Biliary d/o
Pancreatitis
Liver impairment
Heavy alcohol use
Those w/out gallbladder

24

What are ADEs of eluxadoline?

Nausea, constipation, abd pain

Pancreatitis

CNS depression

25

What is increased in those who suffer from diarrhea-predominant IBS?

Postprandial levels of 5-HT