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Drugs for Treatment of Diarrhea-Predominant IBS01:17

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Diarrhea-predominant irritable bowel syndrome (IBS-D) is a subtype of IBS characterized primarily by frequent, loose, or watery stools, abdominal pain, and abdominal discomfort. Therapeutic approaches to managing IBS-D include dietary changes, stress management techniques, and pharmaceutical interventions.
Two specific drugs used in the treatment are alosetron (Lotronex) and eluxadoline (Viberzi). Alosetron, a 5-HT3 antagonist, works by slowing the movement of stools in the gut, reducing bowel...
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Prokinetic agents are specialized medications that stimulate gastrointestinal (GI) motility, promoting food movement through the GI tract. Dopamine, an inhibitory neurotransmitter, plays a significant role in this process, reducing GI motility and indirectly controlling the speed of digestion. Dopamine receptor antagonists, such as metoclopramide and domperidone, offer a unique advantage as prokinetic agents. By blocking the dopamine receptors, these drugs increase GI motility, improving food...
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Certain drugs can affect how neurotransmitters called catecholamines, are released or taken back up in the adrenergic neuron. They can have different effects on the body's sympathetic transmission. Reserpine, a natural compound found in the Rauwolfia shrub, blocks a transporter called vesicular monoamine transporter (VMAT), which leads to a buildup of catecholamines in the cell and reduces sympathetic transmission. Another drug called guanethidine works in multiple ways, including blocking...
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Pharmacological therapies for IBS-C are designed to alleviate abdominal discomfort and enhance bowel function. In patients with IBS-C, fiber supplements may help soften stools and decrease straining, but may also lead to increased gas production and bloating. Osmotic laxatives like milk of magnesia are frequently used to soften stools and increase stool frequency in IBS-C patients. In addition, two drugs approved for use in severe IBS-C adult cases are linaclotide (Linzess) and lubiprostone...
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The activation of the sympathetic nervous system and the renin-angiotensin-aldosterone system (RAAS) contributes to cardiac remodeling, and inhibiting the RAAS is a pharmacological target in heart failure management. As a result, neurohumoral modulation is a crucial treatment principle for managing heart failure. This approach involves using medications like ACE inhibitors (ACEIs), angiotensin receptor blockers (ARBs), β-blockers, mineralocorticoid receptor antagonists (MRAs), and neutral...
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Centrally acting muscle relaxants reduce muscle tone and tension by interfering with the postsynaptic reflexes in the central nervous system.
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[Drugs for Neurogenic Bladder Dysfunction].

Ryuji Sakakibara1, Setsu Sawai, Tsuyoshi Ogata

  • 1Neurology, Sakura Medical Center, Toho University.

Brain and Nerve = Shinkei Kenkyu No Shinpo
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Summary
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Urinary dysfunction, including overactive bladder and retention, stems from various neurological conditions. Treatments aim to improve quality of life and prevent severe complications like kidney dysfunction.

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Area of Science:

  • Neurology
  • Urology

Context:

  • Urinary dysfunction encompasses overactive bladder (OAB) and post-void residual (PVR)/retention.
  • Neurological conditions are primary causes, with brain diseases linked to OAB, peripheral neuropathies to PVR/retention, and multisystem atrophy/spinal cord diseases to both.

Purpose:

  • To outline the causes and treatments for urinary dysfunction.
  • To highlight therapeutic strategies for managing OAB and PVR/retention.

Summary:

  • OAB is treated with beta 3 adrenergic agonists or anticholinergic agents.
  • Significant PVR/retention is managed with clean intermittent self-catheterization, alpha-blockers, and cholinergic stimulants.

Impact:

  • Effective management can enhance patients' quality of life.
  • Timely treatment helps prevent serious complications such as urosepsis and kidney dysfunction.