By T. Georg. Weber State University.
Multiple drugs are commonly used to treat these conditions discount 250 mg ampicillin with amex. Many of these drugs are available over the counter and have been available for decades cheap 500mg ampicillin otc. Despite the high 2 buy 250 mg ampicillin free shipping, 70 prevalence and the enormous socioeconomic burden associated with these conditions, results of our review highlight that for most treatments, objective evidence from well-conducted studies on efficacy and safety is largely missing. For medications that are considered first-line treatments such as bulking agents or stool softeners, solid evidence is missing or of questionable methodological quality. Even for drugs that are considered first- line prescription medications such as osmotic laxatives, the evidence is sparse and fraught with severe methodological problems. Although we revised our eligibility criteria while conducting this report to include any controlled prospective study, regardless of design, we could not find any studies on the efficacy and safety of docusate calcium, docusate sodium, and lactulose for the treatment of chronic constipation or IBS-C. A systematic review reported some low-quality evidence supporting the use of lactulose for occasional 71 constipation. However, these findings cannot be extrapolated to populations with chronic constipation or IBS-C. Although multiple studies support the general efficacy of PEG 3350 for the treatment of chronic constipation in adults and children, most of them are short-term (i. The general safety evidence from three RCTs (1 fair and 2 poor quality) suggests PEG 3350 is well tolerated with only minor adverse events (nausea, gas, cramps, and diarrhea). High quality evidence supports the efficacy of tegaserod for the treatment of chronic constipation in adults and children and IBS-C. However, tegaserod has been taken off the market because of safety concerns due to a recent analysis reporting an increased risk of cardiovascular events. Several previous studies on the general safety and tolerability of tegaserod consistently reported an increased incidence of diarrhea compared to placebo. At present it remains unclear whether tegaserod will be re-approved for selected indications in the future. Constipation Drugs Page 68 of 141 Final Report Drug Effectiveness Review Project Multiple RCTs provide evidence on the efficacy and safety of lubiprostone for the treatment of chronic constipation. However, all these trials have been published as abstracts only. Therefore, no firm conclusions about the net benefits or harms of lubiprostone for the treatment of chronic constipation can be drawn. With regard to tolerability and safety, the 23, 54, 55, 72 incidence of nausea was consistently higher in patients on lubiprostone than on placebo. In phase III trials, 10% of patients on lubiprostone discontinued treatment because of adverse events, mainly 71 gastrointestinal symptoms. Evidence comparing one agent with another is similarly sparse.
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