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Opioid constipation

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https://www.readbyqxmd.com/read/28529168/opioids-in-gastroenterology-treating-adverse-effects-and-creating-therapeutic-benefits
#1
Michael Camilleri, Anthony Lembo, David A Katzka
The use of opioid medications on both an acute and chronic basis is ubiquitous in the U.S. As opioid receptors densely populate the gastrointestinal tract, symptoms and side effects can be expected in these patients. In the esophagus, dysmotility may result manifesting with dysphagia and a syndrome indistinguishable from primary achalasia. In the stomach, a marked delay in gastric emptying may ensue with postprandial nausea and early satiety. Postoperatively, particularly with abdominal surgery, opioid induced ileus may ensue...
May 18, 2017: Clinical Gastroenterology and Hepatology
https://www.readbyqxmd.com/read/28521200/patterns-of-kratom-use-and-health-impact-in-the-us-results-from-an-online-survey
#2
Oliver Grundmann
BACKGROUND: Kratom preparations have raised concerns of public health and safety in the US. Investigation into the demographics, perceived beneficial and detrimental effects of Kratom as well as common doses and purposes of its use are important to properly evaluate its potential health impact. METHODS: An anonymous cross-sectional online survey was conducted in October 2016 of 10,000 current Kratom users through available social media and online resources from the American Kratom Association...
May 10, 2017: Drug and Alcohol Dependence
https://www.readbyqxmd.com/read/28515426/tolerability-of-opioid-analgesia-for-chronic-pain-a-network-meta-analysis
#3
Zengdong Meng, Jing Yu, Michael Acuff, Chong Luo, Sanrong Wang, Lehua Yu, Rongzhong Huang
Aim of this study was to study the tolerability of opioid analgesia by performing a network meta-analysis (NMA) of randomized-controlled trials (RCTs) which investigated effectiveness of opioids for the management of chronic pain. Research articles reporting outcomes of RCT/s comparing 2 or more opioid analgesics for the management of chronic pain were obtained by database search. Bayesian NMAs were performed to combine direct comparisons between treatments with that of indirect simulated evidence. Study endpoints were: incidence of adverse events, incidence of constipation, trial withdrawal rate, and patient satisfaction with treatment...
May 17, 2017: Scientific Reports
https://www.readbyqxmd.com/read/28505689/-pain-management-in-palliative-care
#4
Martin B Steins, Corinna Eschbach, Matthias Villalobos, Michael Thomas
A consistent pain management together with treatment of dyspnoea belongs to the main issues in symptom control in particular in palliative thoracic oncology. Together with the medicamentous therapy the psychologic and social circumstances of the affected patients have to be considered as factors influencing the experience of pain. The therapeutic fundament according to the WHO guideline for cancer pain is the opiate based medicamentous adjustment combined with non-opioids. In principle, this should be performed preferably orally, as simply as possible, according to a fix drug schedule and individually adjusted to the needed dosage...
May 2017: Pneumologie
https://www.readbyqxmd.com/read/28504549/determination-of-naloxegol-in-human-biological-matrices
#5
Yan Li, Mark Hoffmann, Paul Severin
AIM: Naloxegol is an oral peripherally acting μ-opioid receptor antagonist approved for the treatment of opioid-induced constipation. Sensitive, robust, bioanalytical methods were required to quantitate naloxegol in human biological matrices as part of the clinical development program. Results/methodology: Analytical plasma samples were prepared using Solid Phase Extraction (SPE) coupled with concentration. The method's linearity was established at 0.1-50 ng/ml with up to 100-fold dilution...
May 15, 2017: Bioanalysis
https://www.readbyqxmd.com/read/28499731/discovery-of-n-substituted-endo-3-8-aza-bicyclo-3-2-1-oct-3-yl-phenol-and-phenyl-carboxamide-series-of-%C3%AE-opioid-receptor-antagonists
#6
Lan Jiang, David T Beattie, John R Jacobsen, Samuel Kintz, Glenmar P Obedencio, Daisuke Saito, Ioanna Stergiades, Ross G Vickery, Daniel D Long
Gastrointestinal dysfunction as a consequence of the use of opioid analgesics is of significant clinical concern. First generation drugs to treat these opioid-induced side-effects were limited by their negative impact on opioid receptor agonist-induced analgesia. Second generation therapies target a localized, peripherally-restricted, non-CNS penetrant drug distribution of opioid receptor antagonists. Herein we describe the discovery of the N-substituted-endo-3-(8-aza-bicyclo[3.2.1]oct-3-yl)-phenol and -phenyl carboxamide series of μ-opioid receptor antagonists...
May 3, 2017: Bioorganic & Medicinal Chemistry Letters
https://www.readbyqxmd.com/read/28493170/eluxadoline-a-review-in-diarrhoea-predominant-irritable-bowel-syndrome
#7
Gillian M Keating
Eluxadoline (Truberzi(®)) is an orally administered, minimally absorbed agent that acts locally in the gastrointestinal tract as a mixed µ-opioid receptor agonist and δ-opioid receptor antagonist. The randomized, double-blind, placebo-controlled, multinational, phase 3 IBS-3001 and IBS-3002 trials examined the efficacy of eluxadoline in patients with diarrhoea-predominant irritable bowel syndrome (IBS-D). The composite response rate (i.e. the proportion of patients with improvement in both worst abdominal pain and stool consistency on ≥50% of days; primary endpoint), was significantly higher in patients receiving eluxadoline 100 mg twice daily than in those receiving placebo after 12 and 26 weeks' therapy...
June 2017: Drugs
https://www.readbyqxmd.com/read/28484877/combined-application-of-diclofenac-and-celecoxib-with-an-opioid-yields-superior-efficacy-in-metastatic-bone-cancer-pain-a-randomized-controlled-trial
#8
Zunyong Liu, Yan Xu, Zhong-Liang Liu, Yi-Zhou Tian, Xiao-Heng Shen
BACKGROUND: Metastatic bone cancer pain is one of the most common clinical cancer pains and is caused by many factors. This study was conducted to explore the clinical efficacy of using two non-steroidal anti-inflammatory drugs (NSAIDs) along with an opioid in treating metastatic bone cancer pain. MATERIAL AND METHOD: A total of 342 patients with a pain score of 7-10 on the visual analog scale (VAS) were recruited for 4 weeks of treatment and randomly assigned to three different groups-one group received two NSAIDs (diclofenac and celecoxib), one group received diclofenac, and one group received celecoxib...
May 8, 2017: International Journal of Clinical Oncology
https://www.readbyqxmd.com/read/28483411/naldemedine-effective-in-treating-opioid-induced-constipation
#9
Vicki Brower
No abstract text is available yet for this article.
May 5, 2017: Lancet Oncology
https://www.readbyqxmd.com/read/28483009/clinical-and-functional-characteristics-of-nursing-facility-residents-with-opioid-induced-constipation
#10
Carrie Allen, Barbara J Zarowitz, Terrence O'Shea, Catherine Datto, Temitope Olufade
OBJECTIVE: Our goal was to determine the prevalence, clinical characteristics, and treatment differences of opioid-induced constipation (OIC) in older adults with noncancer pain compared with opioid-treated patients without OIC. DESIGN: Retrospective database analysis. SETTING: United States nursing facilities: Patients, Participants, facility residents. INTERVENTIONS: None. MAIN OUTCOME MEASURE(S): Minimum data set and prescription claims, pain, impaired cognition, falls, delirium, and drug treatment...
May 1, 2017: Consultant Pharmacist: the Journal of the American Society of Consultant Pharmacists
https://www.readbyqxmd.com/read/28474460/long-term-efficacy-and-safety-of-oxycodone-naloxone-prolonged-release-formulation-up-to-180-90-mg-daily-results-of-the-open-label-extension-phase-of-a-phase-iii-multicenter-multiple-dose-randomized-controlled-study
#11
D Dupoiron, A Stachowiak, O Loewenstein, A Ellery, W Kremers, B Bosse, M Hopp
BACKGROUND: The inclusion of naloxone with oxycodone in a fixed combination prolonged-release formulation (OXN PR) improves bowel function compared with oxycodone (Oxy) alone without compromising analgesic efficacy. In a recent 5-week, randomized, double-blind comparative trial of OXN PR and OxyPR, it could be shown that the beneficial properties of OXN PR extend to doses up to 160/80 mg. METHODS: Bowel function, pain, quality of life (QoL) and safety of OXN PR up to 180/90 mg daily were evaluated in a 24-week open-label extension phase of the 5-week randomized comparative study in patients with non-malignant or malignant pain requiring opioids and suffering from opioid-induced constipation...
May 4, 2017: European Journal of Pain: EJP
https://www.readbyqxmd.com/read/28466424/naldemedine-first-global-approval
#12
Anthony Markham
Naldemedine (Symproic(®)) is an orally active µ-opioid receptor antagonist being developed by Shionogi & Co., Ltd. that has been approved in the USA and Japan for the treatment of opioid-induced constipation. The drug inhibits peripheral µ-opioid receptors such as those present in the gastrointestinal tract and has minimal or no effect on central opioid activity. This article summarizes the milestones in the development of naldemedine leading to its first global approval in the USA for the treatment of opioid-induced constipation in patients with chronic non-cancer pain...
May 2017: Drugs
https://www.readbyqxmd.com/read/28465373/mashiningan-improves-opioid-induced-constipation-in-rats-by-activating-cystic-fibrosis-transmembrane-conductance-regulator-chloride-channel
#13
Yumi Harada, Seiichi Iizuka, Yayoi Saegusa, Sachiko Mogami, Naoki Fujitsuka, Tomohisa Hattori
Opioid receptor stimulants are analgesics used in patients with and without cancer; however, they often cause constipation, resulting in poor adherence and deterioration of the quality of life. Hence, suitable treatments for constipation are required. In this study, we investigated the pharmacological mechanisms of action of mashiningan (MNG), a Kampo medicine used to treat constipation, and evaluated the effect of MNG on opioid-induced constipation in rats. MNG (100 or 300 mg/kg) was orally administered to normal or codeine phosphate (CPH)-induced constipation in rats, and its effect was evaluated on the basis of fecal counts, characteristics, and weight...
May 2, 2017: Journal of Pharmacology and Experimental Therapeutics
https://www.readbyqxmd.com/read/28458356/control-of-constipation-in-patients-receiving-chop-or-chop-like-chemotherapy-regimens-for-non-hodgkin-s-lymphoma
#14
Hiroko Hayashi, Akio Suzuki, Koichi Ohata, Masashi Ishihara, Yushi Kubota, Ryo Kobayashi, Yuhei Shibata, Hiroshi Nakamura, Nobuhiko Nakamura, Junichi Kitagawa, Hisashi Tsurumi, Masahito Shimizu, Yoshinori Itoh
Management of constipation in patients receiving cyclophosphamide, doxorubicin, vincristine and prednisolone (CHOP) or CHOP-like chemotherapy regimens is important for prevention of paralytic ileus. We reported earlier that the laxative action of magnesium oxide is reversed by the concomitant use of antacids in cancer patients receiving opioid analgesics. Here, we assessed the prevalence of prophylactic laxative medication for the control of constipation in patients receiving CHOP or CHOP-like regimens for non-Hodgkin's lymphoma...
2017: Biological & Pharmaceutical Bulletin
https://www.readbyqxmd.com/read/28455085/randomized-controlled-trial-of-intravenous-acetaminophen-for-postcesarean-delivery-pain-control
#15
Brie Altenau, Catrina C Crisp, C Ganga Devaiah, Donna S Lambers
BACKGROUND: Cesarean delivery is a common surgery in the United States, with 1.3 million performed during 2009.(1) Obstetricians must balance the growing concern with opioid abuse, dependence, and side effects with optimal postoperative pain control. Intravenous acetaminophen may represent an additional method to decrease the reliance on opioid medications and improve postoperative pain following cesarean delivery. OBJECTIVE: The objective of the study was to determine whether the administration of intravenous acetaminophen following routine scheduled cesarean delivery would decrease the need for narcotic medications to control postoperative pain...
April 25, 2017: American Journal of Obstetrics and Gynecology
https://www.readbyqxmd.com/read/28445097/phase-iib-randomized-double-blind-placebo-controlled-study-of-naldemedine-for-the-treatment-of-opioid-induced-constipation-in-patients-with-cancer
#16
Nobuyuki Katakami, Koji Oda, Katsunori Tauchi, Ken Nakata, Katsunori Shinozaki, Takaaki Yokota, Yura Suzuki, Masaru Narabayashi, Narikazu Boku
Purpose This randomized, double-blind, multicenter study aimed to determine the dose of naldemedine, a peripherally-acting μ-opioid receptor antagonist, for future trials by comparing the efficacy and safety of three doses of naldemedine versus placebo in patients with cancer and opioid-induced constipation. Methods Patients ≥ 18 years old with cancer, an Eastern Cooperative Oncology Group performance status ≤ 2, who had been receiving a stable regimen of opioid analgesics for ≥ 2 weeks, had at least one constipation symptom despite laxative use, and no more than five spontaneous bowel movements (SBMs) during the past 14 days, were randomly assigned (1:1:1:1) to oral, once-daily naldemedine 0...
April 26, 2017: Journal of Clinical Oncology: Official Journal of the American Society of Clinical Oncology
https://www.readbyqxmd.com/read/28428507/-opioid-therapy-and-management-of-side-effects-associated-with-opioids
#17
Toshihiko Nakatani
Opioids are very useful medications to reduce suffering of cancer patients such as refractory pain and dyspnea. We physicians have to use opioids to have good management of pain and suffering associated with cancer including management of side effects caused by opioids. Opioids couple opioid receptors and affect several pharmacological effects. Other than analgesic effect, opioids have some side effects of constipation, nausea and vomiting, respiratory depression. In this chapter, I take important side effects of constipation, nausea and vomiting and respiratory depression...
April 2017: Gan to Kagaku Ryoho. Cancer & Chemotherapy
https://www.readbyqxmd.com/read/28428506/-a-new-therapeutic-approach-for-cancer-related-breakthrough-pain-focused-on-oral-transmucosal-fentanyl
#18
Kinomi Yomiya, Masayuki Kaneshima, Beni Kyosaka, Etsuko Warita, Rie Hosonuma, Shinnosuke Osato
In 2013, oral transmucosal fentanyl was first approved in Japan for reducing breakthrough pain(BTP). The development of BTP may contribute to less-effective analgesia, a reduced satisfaction with analgesia therapy, obstacles in daily life, mood disorders, and an increased use of healthcare resources. In most BTP, both the duration from BTP onset to its maximum intensity and the overall duration of BTP episodes are relatively short. The need for improved rapid pain relief for BTP in this setting has led to the development of rapid-onset opioids(ROOs), including oral transmucosal fentanyl citrate(OTFC)...
April 2017: Gan to Kagaku Ryoho. Cancer & Chemotherapy
https://www.readbyqxmd.com/read/28423917/management-of-opioid-induced-constipation-in-hospice-patients
#19
Leah Sera, Mary Lynn McPherson
BACKGROUND: Constipation is a common symptom in patients with advanced disease taking opioids. Opioid-induced constipation (OIC) is commonly treated with laxatives and stool softeners. Recently, newer agents have come to market which broaden options for patients in whom first-line therapies are not effective. OBJECTIVE: To determine what pharmacologic regimens are currently used in hospice programs to prevent and treat OIC, whether those regimens have changed with the introduction of newer agents and evidence discouraging the use of docusate, and whether hospice programs are standardizing the management of OIC...
January 1, 2017: American Journal of Hospice & Palliative Care
https://www.readbyqxmd.com/read/28378462/targeting-multiple-opioid-receptors-improved-analgesics-with-reduced-side-effects
#20
REVIEW
Thomas Günther, Pooja Dasgupta, Anika Mann, Elke Miess, Andrea Kliewer, Sebastian Fritzwanker, Ralph Steinborn, Stefan Schulz
Classical opioid analgesics, including morphine, mediate all of their desired and undesired effects by specific activation of the μ-opioid receptor (μ receptor). The use of morphine for treating chronic pain, however, is limited by the development of constipation, respiratory depression, tolerance and dependence. Analgesic effects can also be mediated through other members of the opioid receptor family such as the κ-opioid receptor (κ receptor), δ-opioid receptor (δ receptor) and the nociceptin/orphanin FQ peptide receptor (NOP receptor)...
April 5, 2017: British Journal of Pharmacology
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