Flashcards in Treatment of IBS Deck (25):
What are pharmacologic therapies directed at?
relieving abd pain & discomfort & improving bowel function
What is the MOA of 5-HT?
Secretion, sensitization, & motility
What is the MOA of linaclotide?
Guanlyate cyclase-c agonist
Stimulates intestinal fluid secretion & transit time
What does linaclotide improve?
What is an ADE of tegaserod (Serotonin 5-HT4 receptor agonist) ?
Increased # of CV deaths
Removed from market except in the emergency situation
What is the MOA of loperamide?
Inhibits peristalsis, prolongs transit time, & reduces fecal volume
What sx are NOT relieved by loperamide?
bloating, abd discomfort
What are the dosing instructions for loperamide?
2mg 45 mins before a meal on regularly scheduled doses
What is the MOA of eluxadoline?
Mixed mu-opioid receptor agonist, delta-opioid receptor antagonist & kappa opioid receptor agonist
Reduces abd pain & diarrhea
What is 2nd line therapy for IBS-D?
Bile acid sequestrants
What are ADEs of bile acid sequestrants?
GI sx: bloating, flatulence, abd discomfort, constipation
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
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
Describe the efficacy of alosetron
Reduces abd pain, cramping, urgency, & diarrhea
What is an ADEs of alosetron?
Ischmic colitis (3/1000 pts, some fatal)
Describe the pharmacotherapy of chronic abd pain
TCAs appear helpful
Alter processing of visceral afferent info
Alter receptors for enteric NTs s/a serotonin
Name 2 antispasmodics (anticholinergics) that are used in IBS
What are ADEs of antispasmodics (anticholinergics)?
Higher doses --> Dry mouth, visual disturbances, urinary retention, & constipation
What are possible causes of IBS?
Altered bowel motility
IBS treatment usually consists of low FODMAP diet. What does FODMAP stand for?
What are the 2 types of 5-HT that exist within the gut?
Serotonin type 3 & 4
What is the MOA of serotonin 5-HT4 receptor agonists (tegaserod)?
Stimulates release of NTs & increases colonic motility
What is eluxadoline contraindicated in?
Heavy alcohol use
Those w/out gallbladder
What are ADEs of eluxadoline?
Nausea, constipation, abd pain