LUBIPROSTONE

LUBIPROSTONE
(lu-bi-pros'tone)
Amitiza
Classifications: laxative and stool softener; prostaglandin; chloride channel activator;
Therapeutic:laxative and stool softener
; prostaglandin
Prototype: Misoprostol
Pregnancy Category: C

Availability

24 mcg capsule

Action

Lubiprostone activates chloride channels in the intestine that enhance chloride-rich intestinal fluid secretion without changing serum sodium and potassium concentrations.

Therapeutic Effect

The increase in intestinal fluid secretion enhances intestinal motility, thereby increasing the passage of stool and alleviating symptoms associated with chronic idiopathic constipation.

Uses

Treatment of chronic idiopathic constipation.

Contraindications

Hypersensitivity to lubiprostone or misoprostol; history of mechanical GI obstruction: Crohn's disease, volvulus, diverticulitis, etc.; severe diarrhea; pregnancy (category C), lactation. Safe use in children is unknown.

Cautious Use

GI disease.

Route & Dosage

Chronic Idiopathic Constipation
Adult: PO 24 mcg b.i.d.

Administration

Oral
  • Administer with food to minimize nausea.
  • Do not administer to a patient with severe diarrhea or suspected bowel obstruction.
  • Store at 15°–30° C (59°–86° F).

Adverse Effects (≥1%)

Body as a Whole: Chest pain, peripheral edema, pyrexia. CNS: Anxiety, depression, dizziness, fatigue, headache, insomnia. CV: Hypertension. GI: Abdominal pain and discomfort, constipation, diarrhea, dry mouth, dyspepsia, flatulence, viral gastroenteritis, gastroesophageal reflux disease, loose stools, nausea, vomiting. Musculoskeletal: Arthralgia, back pain, pain in extremities. Respiratory: Bronchitis, cough, dyspnea, nasopharyngitis, sinusitis, upper respiratory infection. Urogenital: Urinary tract infection.

Pharmacokinetics

Absorption: Very low. Peak: 1.1 h (M3). Distribution: 94% protein bound. Metabolism: Extensive non-hepatic metabolism. Elimination: Urine (major) and feces. Half-Life: 0.9–1.4 h.

Nursing Implications

Assessment & Drug Effects

  • Monitor for and report S&S of bowel obstruction.
  • Lab tests: Baseline LFTs.

Patient & Family Education

  • Follow directions for taking the drug (see Administration).
  • Report to physician if you experience severe or prolonged diarrhea, or new or worsening abdominal pain.
  • Do not drive or engage in potentially hazardous activities until response to drug is known.

Common adverse effects in italic, life-threatening effects underlined; generic names in bold; classifications in SMALL CAPS; Canadian drug name; Prototype drug

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