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Guanylate Cyclase-C Agonists Examples: Linaclotide, Plecanatide Mechanism: cGMP activates CFTR channels intestinal fluid secretion accelerate transit Uses: Chronic constipation, IBS-C Adverse Effects: Diarrhea, abdominal pain Bulk-forming safest, long-term use Osmotic acute or hepatic encephalopathy (lactulose) Stimulants short-term only Stool softeners post-surgery, hemorrhoids Lubricants avoid long-term Chloride channel activators & GC-C agonists newer agents for chronic constipation Mnemonic for Laxatives: BOSS-LC B Bulk-forming O Osmotic S Stimulant S Stool softeners L Lubricant C Chloride channel activators / cGMP agonists Laxative Types and Mechanisms for Constipation Relief Laxatives Laxatives are drugs that promote bowel movements to relieve constipation or clear the bowel before procedures

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