IBS treatment Flashcards
PEG moa
osmotic agent that binds water and causes water to be retained within the stool; stimulates stretch receptors to increase cholinergic activity in enteric nervous system
psyllium, methyl-cellulose, and polycarbophil moa
absorb liquid in the GI tract, thereby altering intestinal fluid and electrolyte transport and causing stool expansion and increased peristalsis and bowel motility
linaclotide moa
activates guanylate cyclase-C receptor to increase intracellular cGMP, which stimulates the CTFR channel, causing Cl- and HCOz- secretion into the lumen; this increases GI fluid, which accelerates transit
lubiprostone moa
PGE1 derivative that directly activates plasma chloride channel (ClC-2) to increase GI fluid secretion and accelerate motility
PEG adverse effects
infrequent flatulence, nausea, abdominal pain, bloating and cramping
psyllium, methyl-cellulose, and polycarbophil adverse effects
rarely abdominal pain or cramps, diarrhea, increased flatulence, nausea, or vomiting
linaclotide adverse effects
contraindicated in neonates infants,and children <6; diarrhea, usually within 2 weeks of treatment initiation
lubiprostone adverse effects
dose-related nausea
alosetron moa
selective antagonist at 5-HT3 receptors extensively distributed on enteric neurons in the GI tract
loperamide moa
direct action on the circular and longitudinal muscles of the intestinal wall to slow motility
anti-cholinergics moa
competitive post-ganglionic muscarinic receptor antagonist
TCAs moa
reduced reuptake of norepinephrine and serotonin in the CNS; some have strong anticholinergic activity
SSRIs moa
selective serotonin reuptake blockade at neuronal membrane, enhancing actions of 5-HT in CNS
rifaximin moa
oral rifampin analog, selectively inhibits bacterial and mycobacterial DNA-dependent RNA polymerase
alosetron adverse effects
BBW: pre-existing colitis, severe constipation; constipation is the most common adverse effect; rarely arrhythmia; physicians must enroll in the prescribing program
