IBS Constipation

MOA: a locally acting selective Cl- channel activator of "CIC-2" that produces a CL- rich intestinal fluid w/o alteration of Na+ and K+ serum levels. This fluid production increases GI motility clearing intestinal of stool

opiod induced constipation in adults with chronic non-cancer pain

low systemic activity or absorption past the GI epithelial membrane

processed by carbonyl reductase in the stomach and jejunum

Contraindicated in patients with history of mechanical bowel obstruction

MOA: Serotonin -HT4 receptor partial agonist---stimulates the peristaltic reflex, increases intestinal secretions and inhibits visceeral sensitivity

Withdrawn from market: 1st drug used to make compassionate use programs

short term treatment of IBS in woman only

MOA: Both linaclotide and its active metabolite are guanylate cyclase-C agonists and act locally on the luminal surface of the intestinal epithelium. Activation of GC-C results in an increase in both intra and extracellular concentrations of cGMP. Increase in cGMP stimulates secretion of chloride and bicarbonate into intestinal lumen 

Contraindicated in pediatric patients up to 6

MOA: Both plecanatide and its active matbolite bind to GC-C and act locally on the luminal surface of the intestinal epithelium. Elevation of Intracellular cGMP stimulates secretions into lumen

contraindicated in patients less than 6

RISK OF SERIOUS DEHYDRATION IN PED'S PATIENTS

MOA: Serotonin-4 (5-HT4) receptor agonist, stimulates colonic peristalsis, which increases bowel motility

Substrate of CYP3A4 and P-gp

Suicidal ideation and behavior

MOA: a simple monosaccharide, lactitol exerts an osmotic effect, causing the influx of water into the small intestine leading to a laxative effect