1. Example of antispasmodic/anticholinergic
    • Dicyclomine hydrochloride (Bentyl)
    • Hyoscyamine sulfate (Levsin)
  2. Hallmark of IBS
    abdominal discomfort or pain
  3. Common symptoms in IBS
    • abdominal discomfort or pain that is relieved after a bowel movement (Hallmark Sx)
    • Alternating periods of diarrhea and constipation
    • Change in stool frequency
    • Passing Mucus from rectum
    • Bloating
  4. Colitis aka ....
    Irritable bowel disease.
  5. 45% of patients stated that IBS interfered with ......
    sex life
  6. To dx IBS patient must have sx for how long?
    12 weeks for the last 12 months.  Does not have to be consecutive 12 weeks.
  7. DX of IBS must have 2 of the following sx
    • 1. Relieved after BM
    • 2. Onset associated with change in frequency of stool
    • 3. Onset associate with change in form of stool.
  8. MOA of antispasmodic/anticholinergic drugs/ anti muscarinic drugs.
    decrease motility, relax smooth muscle tone in GI tract, decrease secretions
  9. Drugs only for the tx of IBS in women
    • Tegaserod (Zelnorm)- constipation main sx
    • Alosetron (Lotronex)- severe IBS and have not responded to other tx  (diarrhea is main sx)
  10. Cornerstone of tx for IBS
    Diet with adequate fiber

    Fluid and fiber have to be increased.
  11. Pain in IBS treated with
  12. Treatment for constipation with IBS
    bulk forming laxatives
  13. Geriatrics and antispasmodics
    • lower doses
    • may have adverse affects such as agitation, confusion, excitement, or delusions.
    • At risk for falls from OD
  14. Patient Education for antispasmodics
    • refrain from activities that require mental alertness
    • stay out of hot and humid environments
    • take 30-60 min before meal
  15. Bentyl dosage
    20-40 mg qid ac and hs

    Geriatrics- 10mg and slowly increase
  16. Alosetron (Lotrenox)
    Black box warning
    • potential serious GI adverse reactions
    • -ischemic collitis
    • -serious constipation

    Discontinue immediately if patient develops colitis (even if GI specialist started)
  17. Reglan indications
    • gastroparesis
    • severe GERD
    • prevention of chemo n/v
  18. Reglan MOA
    stimulates upper GI tract

    Accelerates gastric emptying.
  19. Patient education and Reglan
    • NO ETOH
    • Do not operate heavy machinery
    • Notify provider of any EP symptoms (tardive dyskinesia)
  20. Two drugs used to treat ulcerative colitis

    • sulfasalazine
    • mesalamine
  21. Actigall
    used to dissolve gallstones when patients refuse surgical intervention or are high risk surgery candidates.

    Can be used prophylactically as gallstone prevention.
Card Set
Pharm midterm fall 2013