IBS Medication Management Flashcards
What are 3 modifying agents of the gut bacteria?
- Probiotics
- Antibiotics
- Rifaximin
What agent in probiotics has the most benefit?
Bifidobacterium
What has the most significant improvement in bloating and flatulence?
Probiotics
What is the MOA for antispasmodics?
Relax smooth muscle and attenuation of visceral hypersensitivity and pain sensation
What are antispasmodics recommended for?
Symptomatic short term relief of IBS symptoms
True or false: Antispasmodics can be used for long term therapy
False
What 4 agents are antispasmodics?
- Hyosycamine
- Scopolamine
- Dicyclomine
- Donnatol
How long should a patient be on bentyl?
7 days
What is the most common side effect for antispasmodics?
Heat intolerance
What are the most common ADEs for scopolamine, hyoscyamine, and dicyclomine? 3
- Drowsiness
- Heat intolerance
- Constipation
What 2 things are frequent co-morbidities with IBS?
- Depression
- Anxiety
What antidepressant class is utilized in IBS?
TCAs
What doses for antidepressants are utilized in IBS?
Sub-depression doses
What type of IBS are TCAs used for?
All types
What are the 3 TCAs used for IBS?
- Amitriptyline
- Doxepin
- Desipramine
What 3 drugs are mainly used in IBS-D?
- Rifaximin
- Alosetron
- Eluxadoline
What does Rifaximin inhibit?
Bacterial RNA synthesis
How is Rifaximin dosed?
TID
What are 4 ADRs of Rifaximin?
- Peripheral edema
- Dizziness
- Nausea
- Headache
True or False: alosetron is only utilized in women
True
When can alosetron be used?
In patients who have IBS-D that are unresponsive to conventional therapy
True or false: Alosetron is in the REMS program
True
What do you do if a patient experiences constipation when using Alosetron?
Hold therapy until it resolves
If a patient experiences _____ with Alosetron, you should discontinue therapy and DO NOT restart
Ischemic colitis
What mu-opioid receptor agonist can be used for IBS?
Eluxadoline