Gastrointestional

Question 1

What is the antidiarrheal medication for women only?

Answer 1

Lotronex (alosetron), REMS program risk of severe constipation and ischemic colitis

Question 2

What is the recommended daily amount of fiber for women and men

Answer 2

20-28g for women

30-38g for men

Inc fiber by ~5g/wk + inc as tolerated + inc fluid intake to 5-8, 8oz/day

Question 3

T/F: the algorithm for constipation is stop offending agent, lifestyle modifications, osmotic lax, stimulant lax, suppositories/enema, prucalopride or lubiprostone

Answer 3

True. consider dc after 2-4 weeks of normal stool passage

Question 4

What electrolyte disturbance can osmotic laxatives cause?

Answer 4

hypomagnesemia

Question 5

What electrolyte and vitamin disturbances are we concerned with when using stimulant laxatives?

Answer 5

hypokalemia, salt wasting, and protein deficiency

Question 6

T/F: Recommended to taper off PPI if used longer than 6 months

Answer 6

True, rebound hyper secretion of acid

Question 7

Which 3 medications for constipation can be used for OIC after two failed trials with docusate and stimulants?

Answer 7

Methylnaltrexone (Relistor)
Naldemedine (Symproic)
Naloxegol (Movantik)