Irritable Bowel Syndrome (IBS)

Question 1

It’s an disorder of the lower intestinal tract. It involves abdominal pain and abnormal bowel movements.

• Treatment involves

Answer 1

• Lifestyle changes may be helpful. Regular exercise
• Dietary changes can be helpful. Increasing fiber and avoiding foods/drinks that stimulates intestines may help
• Other possible treatments may include:
• Counseling of cases of anxiety or depression
• Anti-diarrhea if main sx is diarrhea
• Medications to stimulate bowel movements for those with constipation
• Low-dose antidepressants

Question 2

Lotronex

• MOA
• Indication
• Frequency
• CI
• BBW
• Program require

Answer 2

Alosetron

• MOA: Selective 5-HT3 receptor antagonist
• Indication: Diarrhea IBS in WOMEN who have failed conventional therapy
• Dosage: 0.5-1mg PO BID
• CI: fluvoxamine
• BBW: sever constipation, acute ischemic colitis. D/C immediately if constipate.
• Program: prescribers must be enrolled in the Prescribing Program for Lotronex (PPL). Pt sign a Patient Acknowledgment Form. Pharmacists can only dispense prescription that have PPL sticker. Telephone orders, faxed orders, or computer generated prescriptions are not allowed. Refills are permitted on written prescriptions.

Question 3

Imodium

• MOA
• Indication
• Dose

Answer 3

Loperamide

• MOA: Reduces muscular contractions of the intestine
• Indication: diarrhea
• Dose: 4mg initially, then 2mg after each unformed stool. Max OTC 8mg/Rx 16mg per day

Question 4

Amitiza

• MOA
• Indication/dose

Answer 4

Lubiprotestone

• MOA: Increase fluid secretion and motility in the intestines

Indication/dose
- Chronic idiopathic constipation in adults:
.,…..24mcg BID with MEALS
- IBS w/ constipation in women > 18 y.o: 8 mcg BID
- Opioid induce constipation

Question 5

Linzess

• MOA
• Indication
• Storage
• SE

Answer 5

Linaclotide

• MOA: Guanylate cyclase-C agonist. Inc Cl and bicarbonate into the intestinal lumen causing an increase in fluid and GI transit time.

Indication:

• Chronic idiopathic constipation in adults
• IBS w/ constipation
• Storage: sensitive to moisture. Keep caps in descant
• SEs: #1: diarrhea, abdominal pain

Question 6

Zelnorm

• Indication
• Program

Answer 6

Tegaserod

Indication:

• Chronic idiopathic constipation in adults
• IBS w/ constipation

Program:
- FDA made it available ONLY to physicians for patients in emergency situations.

Question 7

Lotronex

• MOA
• Indication
• Dosage
• CI

Answer 7

Alosetron

• MOA: Selective 5-HT3 receptor antagonist
• Indication: Diarrhea IBS in WOMEN who have failed conventional therapy
• Dosage: 0.5-1mg PO BID
• CI: fluvoxamine