What is the criteria of IBS? - ✔✔ROME IV criteria: require that pt have had recurrent abd pain on
average at least 1 day per week during the previous 3 months that is associated with two or more of the
following
1. related to defecation
2. associated with a change in stool frequency
3. associated with a change in stool form or appearance
What is used to treat IBS-C? - ✔✔polyethylene glycol 3350 (miralax)
bulk-forming agents
Lubiprostone (amitizia)
Guanylate cyclase agonist
Sodium/hydrogen exchanger 3 (NHE3)
What is polyethylene glycol 3350 (Miralax)? - ✔✔osmotic laxative
2022 recommend with low certainty evidence
What is the MOA of polyethylene glycol? - ✔✔cause fluid to be drawn into the bowel lumen through
osmosis, which distends the colon and increases peristalsis
What is the onset of action of polethylene glycol? - ✔✔24-96 hours
What are the adverse effects of polyethylene glycol? - ✔✔abdominal cramps, diarrhea, dyspepsia,
nausea
What are the bulk foming agents? - ✔✔psyllium (Metamucil)
Calcium polycabophil (Fibercon0
Methylcellulose (citrucel)
, What is the MOA of bulk forming agents? - ✔✔form gel-like matrix in the stool, soaking up fluid in stool,
and adding bulk to the stool
What are the contraindication of bulk forming agents? - ✔✔fecal impaction, GI obstruction
What is the onset of action of bulk forming agents? - ✔✔12-72 hours
take 2 hours before/after other drugs can affect other drugs
What is required for the fx of bulk forming agents? - ✔✔adequate fluids re required
What are the adverse effects of bulk forming agents? - ✔✔increased gas, bloating, bowel obstruction
bulking agents effect on abdominal pain - ✔✔no improvement in abdominal pain over placebo
What is lubiprostone (amtizia) MOA? - ✔✔chloride channel activator that act locally on the apical
membranes of intestinal epithelial cell to increase fluid secretion and improve fecal transit
What is lubiprostone (amitiza) approved for? - ✔✔women 18 and older
What does lubiprostone need to be administered with? - ✔✔food
How long does it take for sx releif with lubiprostone (amiztiza)? - ✔✔month
What are the adverse effects of lubiprosotne (amitizia)? - ✔✔nausea, diarrhea, headache, hypokalemia
When is lubiprostone (Amitizia)? - ✔✔pt that have severe diarrhea to the stronger medications
What are the guanylate cyclase agonists? - ✔✔linaclotide (linzess)
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