Which laxative acts by opening of Chloride channels ?
**Core Concept**
Lubiprostone is a chloride channel activator used in the management of chronic constipation. Its mechanism of action involves the opening of chloride channels in the intestinal epithelium, which increases the amount of water and chloride ions in the intestinal lumen, promoting laxation.
**Why the Correct Answer is Right**
Lubiprostone works by activating the cystic fibrosis transmembrane conductance regulator (CFTR) chloride channels on the apical surface of intestinal epithelial cells. This results in an increase in chloride secretion into the intestinal lumen, which in turn increases water secretion and promotes laxation. The increased chloride secretion also helps to reduce the absorption of water from the intestinal lumen, further exacerbating the laxative effect.
**Why Each Wrong Option is Incorrect**
**Option A:** Docusate is a stool softener that works by increasing the wetting of the stool by bile salts, making it easier to pass. It does not act by opening chloride channels.
**Option B:** Anthraquinone laxatives, such as senna, work by stimulating the enteric nervous system to increase peristalsis and promote bowel movements. They do not involve the opening of chloride channels.
**Option D:** Bisacodyl is a stimulant laxative that works by increasing peristalsis through its action on the enteric nervous system. It does not involve the opening of chloride channels.
**Clinical Pearl / High-Yield Fact**
Lubiprostone is particularly useful in patients with chronic constipation who have not responded to other laxatives or have underlying conditions that make bowel movements difficult, such as irritable bowel syndrome (IBS) or opioid-induced constipation.
**✓ Correct Answer: C. Lubiprostone**