IBS Treatment Flashcards
Lubiprostone Trade Name
Amitiza
Lubiprostone MOA
- selective chloride channel activator
- increase intestinal fluid secretion
- improve stool consistency
- increase intestinal motility
Lubiprostone Indication
chronic idiopathic constipation
Lubiprostone AEs
- nausea most common
- D/V
- abd pain/distention, gas
- HA, dizziness
- peripheral edema, dyspnea, arthralgia
Lubiprostone CIs
-hx of mechanical GI obstruction
Lubiprostone Dose
24 mcg bid with meals ($200 month)
Linaclotide Trade Name
Linzess
Linaclotide MOA
- increase concentration cGMP which leads to secretion of chloride and bicarbonate into intestinal lumen
- causes an increase in fluid and GI transit
Linaclotide Indication
- IBS with constipation
- chronic idiopathic constipation
Linaclotide AEs
-diarrhea and abd pain
Linaclotide CI
- known or suspected mechanical GI obstruction
- age < 6 years (Avoid 6-17 yo)
Linaclotide Dose
290 mcg po qday on empty stomach
-swallow whole >30 mins before 1st meal
Special Considerations Linaclotide
- frequently stopped due to AEs
- 3rd or 4th line for IBS-C
Tegaserod Trade Name
Zelnorm
Tegaserod MOA
- 5HT4 partial agonist for short term treatment of constipation predominant IBS in women
- increase the movement of stools through the bowels
Tegaserod Indications
- currently only available in US through investigational limited access program
- women under 55 with diagnosis of IBS-C or idiopathic constipation and no satisfactory response to other available tx
Tegaserod AEs
- mild HA
- abd pain and D
- linked to heart attacks, strokes, unstable angina
Tegaserod Warnings
- potential for serious consequences of diarrhea
- precaution about ischemic colitis and other forms of intestinal ischemia
Tegaserod CIs
- renal or hepatic impairment
- pts with hx of bowel obstruction
Tegaserod Dose
6 mg bid ac x4-6 wks
Alosetron Trade Name
Lotronex
Alosetron MOA
- 5HT3 receptor antagonist
- can delay whole gut transit time, increase colonic transit time and alter colon’s reaction to distention
Alosetron Indication
-only for tx of women with severe, diarrhea predominant IBS who have failed to respond to conventional IBS therapy
Alosetron AEs
-serious and unpredictable GI adverse events, including some that resulted in death
