IBS Tx Flashcards

1
Q

What is IBS

A

idiopathic chronic disorder with abdominal discomfort, pain, bloating, distention or cramps in association with diarrhea, constipation or both

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2
Q

goals therapy IBS

A

relieve abdominal pain and discomfort and improve bowel function

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3
Q

what are the important first steps in management of IBS

A

patient counseling and dietary change

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4
Q

what is used for IBS with predominant diarrhea

A

loperamide

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5
Q

Tx for IBS predominant constipation

A

osmotic laxatives

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6
Q

what is used to Tx chronic abdominal pain in IBS patients

A

low dose tricyclic antidepressants like amitryptyline

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7
Q

what is the prototype for a serotonin partial agonist

A

tegaserod

available in restricted program form increase risk in ischemic events

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8
Q

what is the prototype of 5-HT3 R antagonist

A

alosetron- restricted use program

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9
Q

what are the other serotonin antagonists on market

A

ondansetron, granisetron, dolasetron, palonosetron

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10
Q

MOA serotonin antagonists

A

inhibits GI afferent R reducing unpleasant sensations

blocks central R reducing visceral afferent stimulation– inhibits colonic motility, increasing transit time

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11
Q

therapeutic use serotonin antagonists

A

women with severe diarrhea from IBS
efficacy in men not established
reduces lower abdominal pain,c ramps, urgency, diarrhea, decreases mean number bowel movements per day and improves stool consistency

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12
Q

adverse effects to serotonin antagonists

A

constipation

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13
Q

Drug interactions wiht serotonin antagonists

A

none

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14
Q

MOA antispasmotics used in IBS and what are drug names

A

dicyclomine and hyoscyamine
inhibit muscarininc cholinergic R in enteric plexus on smooth muscle
high does- excessive anticholinergic effects

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15
Q

What is prototype chloride channel activator in IBS

A

lubiprostone

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16
Q

MOA lubiprostone

A

stimulates type 2 Cl Ch in small intestine and stimulates secretion and dec transt time through small intestine and colon. delays gastric emptying which can cause anorexia and nausea

17
Q

therapeutic use Cl Ch activator

A

women with constipation predominant IBS, efficacy in men unproven

18
Q

adverse effects lubiprostone

A

nausea from delayed gastric emptying