IBS Pharma

Question 1

what is the mechanism of the first line treatment for IBS?

Answer 1

parasympathetic antagonists

Question 2

name the two parasympathetic antagonists used to treat IBS?

Answer 2

hyoscyamine

dicyclomine

Question 3

name two side effects of hyoscyamine and dicyclomine

Answer 3

xerostomia and blurred vision

Question 4

what is the drug used for IBS-D?

Answer 4

eluxadoline

Question 5

what is the MoA of eluxadoline?

Answer 5

Mu opioid receptor agonist…reduces gut motility

Question 6

where does eluxadoline act in the Gi system?

Answer 6

on the myenteric plexus area

Question 7

what is the side effect of eluxadoline?

Answer 7

constipation

Question 8

what are the three drugs used to treat IBS-D?

Answer 8

eluxadoline
alosetron
rifamixin

Question 9

what is the MoA of alosetron?

Answer 9

serotonin antagonist reduces gut motility by inhibitis serotonin signaling from ECL cells

Question 10

what is the bad toxicity of alosetron?

Answer 10

ischemic colitis

Question 11

how does rifamixin treat IBS-D?

Answer 11

reduces activity of gut flora

Question 12

what are the three drugs that help treat the pain coinciding mentally with IBS?

Answer 12

citalopram
duloxetine
desipramine

Question 13

what is off target hit that desipramine can have?

Answer 13

parasymp antagonist

Question 14

what is pepto bismol generic name?

Answer 14

bismuth subsalicylate

Question 15

what should you not be taking with pepto bismol?

Answer 15

any other form of aspirin or NSAID

Question 16

what is the MoA of bismuth subsalicylate?

Answer 16

inhibs COX1/2 like all other NSAIDS

Question 17

what are the names of the two mu receptor opioid agonists that are used to treat general diarrhea? not specific to IBS-D

Answer 17

loperamide

diphenyoxylate

Question 18

what is the issue with loperamide?

Answer 18

can have enough availability that it leads to euphoria and opiate addiction

Question 19

what is the bile acid sequesterant that is used to treat general diarrhea?

Answer 19

cholestyramine

Question 20

when do you give cholstyramine?

Answer 20

if your diarrhea is being caused by malabsorption of bile acid

Question 21

name the three drugs that are osmotic agents that help constipation?

Answer 21

lactulose, polyethylene glycol, and magnesium citrate

Question 22

what is the drug that is similar to osmotic agents for constipation but works on letting water in the stool not the lumen?

Answer 22

Docusate

Question 23

how does docusate work to treat constipation?

Answer 23

decreases ST of water and makes stool easier to penetrate

Question 24

name the two anti constipation drugs that have an unknown mechanismm

Answer 24

Bisacodyl and Senna

Question 25

name the three drugs that activate for Cl to be secreted and water to follow to treat constipation

Answer 25

lubiprostone linaclotide piecanatide

Question 26

what is the MoA of Lubiprostone?

Answer 26

activates the CFTR or chloride channel directly and then H2O pulls with it

Question 27

what is the MoA of Linclotide and Piecanatide

Answer 27

agonize the guanylate cyclase that induces for Cl to be pumped into lumen of GI and H2O will follow

Question 28

what do you give someone if they have opioid induced constipation?

Answer 28

PAMORAs or peripherally acting mu opioid receptor antagonist

Question 29

name the four PAMORAs to know

Answer 29

alvimpoan methylnaltrexone Naldemedine Naloxegol

Question 30

what is a common feature of the colon in all forms of IBS?

Answer 30

spasming of the colon