Table 4 New treatment options for laxative-resistant chronic constipationá…Ÿ
From: Chronic constipation in the elderly: a primer for the gastroenterologist
Drug | Mechanism of action | Effect | Possible side effects |
|---|---|---|---|
Lubiprostone | Type 2 chloride channel (CCl2) activator. | Chloride secretion in the intestinal lumen followed by passive diffusion of sodium and water. | Nausea, headache. |
Increase in faecal content of water with distension of intestinal walls and activation of peristalsis and acceleration of intestinal transit. | |||
Linaclotide Plecanatide | Guanylate cyclase C receptor agonist. | Increase of intra and extra-cellular cyclic guanosine monophosphate. | Dose-dependent diarrhea. |
Increase of secretion of chloride, bicarbonate and water into intestinal lumen. | |||
Activation of peristalsis and acceleration of intestinal transit. | |||
Prucalopride | 5-HT4 serotonin receptor agonist. | Excitatory activity of neurons of the myenteric plexus. | Headache, nausea, diarrhea. |
Norcisapride | Release of acetylcholine. | ||
Velusetrag | Activation of peristalsis and acceleration of intestinal transit. | ||
Elobixibat | Enantiomer of 1,5-benzothiazepine. | Bond and inhibits the ileal bile acid transporter. | Abdominal pain, diarrhea. |
Increased stay of bile acid in the colon. Activation of peristalsis and acceleration of intestinal transit. |