Motegrity Coupon and Constipation Treatment Quiz

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Questions and Answers

What is one of the criteria for the diagnosis of chronic idiopathic constipation (CIC)?

Sudden weight loss

Straining during defecation (correct)

Increased appetite

Presence of blood in stool

Which of the following is NOT a symptom used to diagnose chronic idiopathic constipation (CIC)?

Frequent bowel movements (correct)

Sensation of anorectal obstruction

Manual maneuvers to facilitate defecation

Less than 3 spontaneous bowel movements per week

Which type of laxatives causes soft or semi-fluid stools within 6-12 hours?

Magnesium citrate (correct)

Docusate

Polyethylene glycol

Methylcellulose

What is the main mechanism of action of lactulose as an osmotic laxative?

Metabolism by colonic bacteria Signup and view all the answers

Which agent is classified as an intestinal secretagogue for treating chronic idiopathic constipation?

Lubiprostone Signup and view all the answers

What lifestyle modifications are recommended for initial management of chronic idiopathic constipation?

Increasing fiber, fluids, physical activity Signup and view all the answers

Which medication can result in watery evacuation within 1-6 hours?

Bisacodyl Signup and view all the answers

Which agent is classified as a prokinetic agent used in the treatment of chronic idiopathic constipation?

Prucalopride Signup and view all the answers

'Increase stool frequency' is a pharmacological effect associated with which medication?

Polyethylene glycol Signup and view all the answers

What is the recommended first-line treatment for mild chronic idiopathic constipation (CIC) according to the text?

Fiber Signup and view all the answers

What side effect should be monitored if osmotic laxatives are used for longer than 6 months, especially in elderly patients?

Dehydration Signup and view all the answers

What can be considered as rescue therapy in combination with other pharmacological medications for chronic idiopathic constipation?

Stimulant laxatives Signup and view all the answers

What is the recommended course of action if fiber is not effective at all for chronic idiopathic constipation?

Add a stimulant laxative for 2-4 weeks Signup and view all the answers

What is the suggested duration of treatment with agents approved for chronic idiopathic constipation (CIC) according to the text?

>12 weeks Signup and view all the answers

What should be avoided when a patient cannot move, drink plenty of fluids, or has difficulty swallowing in relation to laxative use?

Bulk laxatives Signup and view all the answers

What is the mechanism of action of Prucalopride (Motegrity)?

Stimulates colonic peristalsis Signup and view all the answers

Which of the following is a contraindication for using Prucalopride (Motegrity)?

Crohn's disease Signup and view all the answers

How frequently should Prucalopride (Motegrity) be administered?

Once daily Signup and view all the answers

Which of the following gastrointestinal symptoms is a potential side effect of Prucalopride (Motegrity)?

Abdominal pain Signup and view all the answers

What should be considered when dosing Prucalopride (Motegrity) for a patient with a creatinine clearance (CrCL) less than 30 mL/min?

Use a lower dose Signup and view all the answers

What outcome is expected during 12-week studies with Prucalopride (Motegrity)?

< 3 BMs per week, on average Signup and view all the answers

Which condition is NOT a contraindication for using Prucalopride (Motegrity)?

Gallbladder stones Signup and view all the answers

What should a patient do if the symptoms of CIC have not improved with fiber and Miralax?

Consult a healthcare provider for further evaluation and management options Signup and view all the answers

Study Notes

Treatment of Chronic Idiopathic Constipation (CIC)

Goals of treatment: relieve symptoms and re-establish normal bowel habits
First-line treatment: fiber (2-4 weeks)
Avoid bulk laxatives in patients who cannot move, drink plenty of fluids, or have difficulty swallowing
If fiber is partially effective or not effective, switch or add an osmotic laxative (Miralax, lactulose, magnesium oxide) for 2-4 weeks
Stimulant laxatives (bisacodyl, senna) are good for occasional use or rescue therapy in combination with other medications
Can be used long-term if the regimen is effective

Osmotic Laxatives

Lactulose: non-absorbable disaccharide that reaches the large bowel, metabolized by colonic bacteria to monosaccharides, increasing stool frequency
Administration: oral solution, mix with fruit juice, water, or milk
Miralax: polyethylene glycol, dissolves in 120 mL water, typically administered once daily

Prokinetic Agent: Prucalopride (Motegrity)

Mechanism of action: selective serotonin type 4 receptor agonist, stimulating colonic peristalsis, increasing bowel motility
Efficacy: ≥ 3 BMs per week, on average, in 12-week studies
Administration: orally once daily, with or without food
Side effects: headache, abdominal pain, nausea, diarrhea
Contraindications: tear in the stomach or intestinal wall, bowel obstruction, Crohn's disease, ulcerative colitis

Diagnosis of Chronic Idiopathic Constipation (CIC)

Symptoms for ≥ 6 months
≥ 2 of the following symptoms for > 25% of defecations during the past 3 months:
- Straining
- Lumpy/hard stools
- Sensation of incomplete evacuation
- Sensation of anorectal obstruction/blockage
- Manual maneuvers to facilitate
- Less than 3 spontaneous BM/week

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Description

This quiz covers information on the clinical presentation of constipation, focusing on recognizing symptoms and identifying factors affecting it. Prepare for in-class exams by studying the provided slides and understanding generic names of medicines.

Pharmacy Practice Quiz: Constipation and Clinical Presentation