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Opioid constipation

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https://www.readbyqxmd.com/read/29207909/the-evolving-role-of-long-term-pharmacotherapy-for-opioid-induced-constipation-in-patients-being-treated-for-noncancer-pain
#1
Brandi L Bowers, Andrew J Crannage
Nationally, the prescription of opioids for acute and chronic pain is increasing. As opioid use continues to expand and become of increased concern for health-care practitioners, so do the adverse effects and long-term management of those effects. Opioid-induced constipation (OIC) presents a unique challenge because tolerance does not develop to this particular adverse effect, making chronic pain management a delicate balance between relieving pain and preventing long-term adverse effects such as constipation and dependence...
January 1, 2017: Journal of Pharmacy Practice
https://www.readbyqxmd.com/read/29186083/naldemedine-symproic-for-opioid-induced-constipation
#2
(no author information available yet)
No abstract text is available yet for this article.
December 4, 2017: Medical Letter on Drugs and Therapeutics
https://www.readbyqxmd.com/read/29149731/purinergic-drug-targets-for-gastrointestinal-disorders
#3
REVIEW
Geoffrey Burnstock, Kenneth A Jacobson, Fievos L Christofi
Purinergic receptors are implicated in the pathogenesis of gastrointestinal disorders and are being explored as potential therapeutic targets. Gut inflammation releases ATP that acts on neuronal, glial, epithelial and immune cells. Purinergic signalling in glia and neurons is implicated in enteric neuropathies. Inflammation activates glia to increase ATP release and alter purinergic signalling. ATP release causes neuron death and gut motor dysfunction in colitis via a P2X7-dependent neural-glial pathway and a glial purinergic-connexin-43 pathway...
November 14, 2017: Current Opinion in Pharmacology
https://www.readbyqxmd.com/read/29147138/an-update-on-prucalopride-in-the-treatment-of-chronic-constipation
#4
REVIEW
Anam Omer, Eamonn M M Quigley
Chronic constipation (CC) is a highly prevalent and often under-appreciated gastrointestinal disorder associated with significant impairment in quality of life. Symptoms of constipation are typically present for a number of years prior to a patient seeking help. Lifestyle modifications followed by, or coupled with, over-the-counter laxatives represent the initial treatment option; however, relief for many is limited and dissatisfaction rates for these approaches remain high. Over recent years, therefore, considerable effort has been exerted on the development of novel pharmacological approaches...
November 2017: Therapeutic Advances in Gastroenterology
https://www.readbyqxmd.com/read/29145012/the-gut-brain-interaction-in-opioid-tolerance
#5
REVIEW
Hamid I Akbarali, William L Dewey
The prevailing opioid crisis has necessitated the need to understand mechanisms leading to addiction and tolerance, the major contributors to overdose and death and to develop strategies for developing drugs for pain treatment that lack abuse liability and side-effects. Opioids are commonly used for treatment of pain and symptoms of inflammatory bowel disease. The significant effect of opioids in the gut, both acute and chronic, includes persistent constipation and paradoxically may also worsen pain symptoms...
November 13, 2017: Current Opinion in Pharmacology
https://www.readbyqxmd.com/read/29139482/opioid-misuse-in-gastroenterology-and-non-opioid-management-of-abdominal-pain
#6
REVIEW
Eva Szigethy, Mitchell Knisely, Douglas Drossman
Opioids were one of the earliest classes of medications used for pain across a variety of conditions, but morbidity and mortality have been increasingly associated with their chronic use. Despite these negative consequences, chronic opioid use is increasing worldwide, with the USA and Canada having the highest rates. Chronic opioid use for noncancer pain can have particularly negative effects in the gastrointestinal and central nervous systems, including opioid-induced constipation, narcotic bowel syndrome, worsening psychopathology and addiction...
November 15, 2017: Nature Reviews. Gastroenterology & Hepatology
https://www.readbyqxmd.com/read/29121158/opioid-use-by-patients-after-rhinoplasty
#7
Sagar Patel, Angela Sturm, Michael Bobian, Peter F Svider, Giancarlo Zuliani, Russell Kridel
Importance: Given the increase in opioid addiction and overdose in the United States, reasoned opioid use after outpatient surgery may affect prescription medication abuse. Objectives: To examine patient use of opioids after rhinoplasty and establish an optimal postrhinoplasty pain management regimen. Design, Setting, and Participants: In this case series, opioid use was evaluated in 62 patients who underwent rhinoplasty performed by 3 fellowship-trained facial plastic surgeons, 2 in private practice in Texas and 1 in an academic setting in Michigan, from February 2016 to September 2016...
November 9, 2017: JAMA Facial Plastic Surgery
https://www.readbyqxmd.com/read/29119706/insights-on-efficacious-doses-of-pamoras-for-patients-on-chronic-opioid-therapy-or-opioid-na%C3%A3-ve-patients
#8
K van Malderen, H Halawi, M Camilleri
BACKGROUND: Opioid-induced constipation (OIC) is a major side effect of opioid use. Centrally acting antagonists result in opioid withdrawal or worsening of pain and lead to use of peripherally acting mu-opioid receptor antagonists (PAMORAs). The required doses of the PAMORAs, methylnaltrexone and naloxegol, in the treatment of OIC are well established in chronic opioid users. OIC may occur after short duration of opioid treatment; the required doses of naloxone, naltrexone, and PAMORAs in opioid-naïve subjects (with no opioid use for at least 3 months) are unclear...
November 9, 2017: Neurogastroenterology and Motility: the Official Journal of the European Gastrointestinal Motility Society
https://www.readbyqxmd.com/read/29098567/oxycodone-naloxone-prolonged-release-a-review-in-severe-chronic-pain
#9
Esther S Kim
Oral oxycodone/naloxone prolonged release (PR) [Targin(®), Targinact(®), Targiniq(®)] is a 12-hourly opioid receptor agonist and opioid receptor antagonist fixed-dose combination product that is approved in countries in the EU for the management of severe pain (adequately manageable only with opioid analgesics) in adults. Oral naloxone prevents oxycodone from binding to μ-receptors in the gastrointestinal (GI) tract, thereby counteracting opioid-induced constipation (OIC). In short-term (5- to 12-week) clinical trials of adults with moderate to severe, chronic pain and OIC (OXN3001, OXN3006, OXN3506), oxycodone/naloxone PR significantly improved OIC while providing noninferior analgesia relative to oxycodone PR; results were consistent between cancer and non-cancer patients in OXN3506...
December 2017: Clinical Drug Investigation
https://www.readbyqxmd.com/read/29097308/analysis-of-natural-product-regulation-of-opioid-receptors-in-the-treatment-of-human-disease
#10
REVIEW
S Badal, S Turfus, R Rajnarayanan, C Wilson-Clarke, S L Sandiford
Opioid receptors (ORs), μOR, δOR, κOR and ORL1 mediate numerous signaling cascades, most importantly, through the modulation of ion channels. Research demonstrates the role of OR mediated signal transduction in treating pain, cancer, neurodegenerative disorders and cardiac insults. Yet, the primary application of drugs that modulate ORs is analgesia. Current opioids like morphine that are mainly μOR orthosteric agonists attract many undesirable side-effects (constipation, urinary retention, respiratory depression and hypotension) and the existing modus operandi against these is the inclusion of a μOR antagonist (for example...
October 30, 2017: Pharmacology & Therapeutics
https://www.readbyqxmd.com/read/29092627/evidence-based-review-of-pharmacotherapy-for-opioid-induced-constipation-in-noncancer-pain
#11
Julie A Murphy, Erica A Sheridan
OBJECTIVE: To summarize and evaluate the existing literature regarding medications to treat opioid-induced constipation (OIC) in patients with chronic noncancer pain (CNCP). DATA SOURCES: PubMed, EMBASE, and Web of Science were searched using the following terms: constipation, opioid, chronic, pain, noncancer, nonmalignant, methylnaltrexone, alvimopan, lubiprostone, naloxegol, and naldemedine. STUDY SELECTION AND DATA EXTRACTION: The search was limited to randomized controlled trials reporting human outcomes...
October 1, 2017: Annals of Pharmacotherapy
https://www.readbyqxmd.com/read/29090081/eluxadoline-in-irritable-bowel-syndrome-with-diarrhea-rationale-evidence-and-place-in-therapy
#12
REVIEW
Kenneth Barshop, Kyle Staller
Irritable bowel syndrome (IBS) is the most common gastrointestinal (GI) disorder worldwide, however treatment options for diarrhea-predominant IBS (IBS-D) remain limited. Eluxadoline, a µ- and κ-opioid receptor agonist and δ-opioid receptor antagonist, was recently approved for the treatment of IBS-D. A novel compound first described in 2008, eluxadoline was shown to normalize GI transit, with a subsequent phase I demonstrating its safety and tolerability in healthy adults. In 2016, two randomized, double-blind, placebo-controlled phase III trials studying eluxadoline use at 75 mg and 100 mg twice daily over 26 weeks demonstrated a significant improvement in stool consistency and many global symptoms of IBS...
November 2017: Therapeutic Advances in Chronic Disease
https://www.readbyqxmd.com/read/29084357/adverse-events-associated-with-medium-and-long-term-use-of-opioids-for-chronic-non-cancer-pain-an-overview-of-cochrane-reviews
#13
REVIEW
Charl Els, Tanya D Jackson, Diane Kunyk, Vernon G Lappi, Barend Sonnenberg, Reidar Hagtvedt, Sangita Sharma, Fariba Kolahdooz, Sebastian Straube
BACKGROUND: Chronic pain is common and can be challenging to manage. Despite increased utilisation of opioids, the safety and efficacy of long-term use of these compounds for chronic non-cancer pain (CNCP) remains controversial. This overview of Cochrane Reviews complements the overview entitled 'High-dose opioids for chronic non-cancer pain: an overview of Cochrane Reviews'. OBJECTIVES: To provide an overview of the occurrence and nature of adverse events associated with any opioid agent (any dose, frequency, or route of administration) used on a medium- or long-term basis for the treatment of CNCP in adults...
October 30, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/29076387/the-efficacy-and-safety-of-transcutaneous-acupoint-interferential-current-stimulation-for-cancer-pain-patients-with-opioid-induced-constipation-a-prospective-randomized-controlled-study
#14
Hua-Dong Zhu, Zhen Gong, Bing-Wei Hu, Qiao-Ling Wei, Jun Kong, Cong-Bin Peng
INTRODUCTION: Opioid-induced constipation (OIC) is a principal complication secondary to analgesic therapy for cancer pain patients who suffer moderate to severe pain. In this study, we observe the efficacy and safety of transcutaneous acupoint interferential current (IFC) stimulation in those patients with OIC. METHODS: A total of 198 patients were randomly allocated to the IFC group and control group in a 1:1 ratio. Finally, 98 patients in the IFC group received 14 sessions administered over 2 weeks, whereas 100 patients in the control group took lactulose orally during the same period...
October 1, 2017: Integrative Cancer Therapies
https://www.readbyqxmd.com/read/29054032/constipation-and-other-common-symptoms-reported-by-women-and-men-in-methadone-and-buprenorphine-maintenance-treatment
#15
Paul S Haber, Mahmoud Elsayed, David Espinoza, Nicholas Lintzeris, Anne-Sophie Veillard, Richard Hallinan
BACKGROUND: Opioid substitution treatment (OST) is often continued long-term and, therefore, opioid-associated symptoms are of interest. Symptoms associated with methadone maintenance treatment (MMT) in men are well described, but there are fewer reports concerning symptoms associated with buprenorphine maintenance treatment (BMT) and very few reports among women. METHOD: Recipients of BMT (n=113) and MMT (n=184), non-opioid users (n=105) and opioid users not receiving OST (n=87) completed the Patient Assessment of Constipation (PAC-SYM) and a general symptom checklist...
October 13, 2017: Drug and Alcohol Dependence
https://www.readbyqxmd.com/read/29032350/identifying-characteristics-of-the-most-severely-impaired-chronic-pain-patients-treated-at-a-specialized-inpatient-pain-clinic
#16
Eva-Britt Hysing, Lena Smith, Mans Thulin, Rolf Karlsten, Stephen Butler, Torsten Gordh
BACKGROUND AND AIMS: Patients suffering from chronic nonmalignant pain constitute a heterogeneous population in terms of clinical presentation and treatment results. Few data are available about what distinguishes different groups in this huge population of patients with chronic persistent pain (CPP). A subgroup that is poorly studied, consists of the most severely impaired chronic pain patients. At the Uppsala University Hospital Pain Clinic, there is a specialized department accepting the most complex patients for rehabilitation...
October 12, 2017: Scandinavian Journal of Pain
https://www.readbyqxmd.com/read/29024708/nationwide-quality-of-hospice-care-findings-from-the-centers-for-medicare-medicaid-services-cms-hospice-quality-reporting-program-hqrp
#17
Nan Tracy Zheng, Qinghua Li, Laura C Hanson, Kathryn L Wessell, Natalie Chong, Noha Sherif, Ila H Broyles, Jennifer Frank, M Alexis Kirk, Carol R Schwartz, Alan F Levitt, Franziska Rokoske
BACKGROUND: With increasing use of the Medicare hospice benefit, policymakers recognize the need for quality measurement to assure that terminally ill patients receive high quality care and have the information they need when selecting a hospice. Towards these goals, CMS has been collecting standardized patient-level quality data via the Hospice Item Set (HIS) since July 1, 2014. OBJECTIVES: This article presents a first look at the national hospice HIS quality data...
October 9, 2017: Journal of Pain and Symptom Management
https://www.readbyqxmd.com/read/29016868/efficacy-and-safety-of-lubiprostone-in-patients-with-opioid-induced-constipation-phase-3-study-results-and-pooled-analysis-of-the-effect-of-concomitant-methadone-use-on-clinical-outcomes
#18
Egilius L H Spierings, Douglas A Drossman, Byron Cryer, M Mazen Jamal, Taryn Losch-Beridon, Shadreck M Mareya, Martin Wang
Objective: The efficacy and safety of oral lubiprostone for relieving symptoms of opioid-induced constipation (OIC) in patients with chronic noncancer pain were evaluated in a randomized, double-blind, placebo-controlled study. These data were also pooled with those from two similar phase 3 studies to explore the effects of methadone on treatment response. Methods: In the primary study, adults with OIC (fewer than three spontaneous bowel movements [SBMs] per week) were randomized to receive lubiprostone 24 mcg or placebo twice daily for 12 weeks...
July 17, 2017: Pain Medicine: the Official Journal of the American Academy of Pain Medicine
https://www.readbyqxmd.com/read/29016552/the-efficacy-of-peripheral-opioid-antagonists-in-opioid-induced-constipation-and-postoperative-ileus-a-systematic-review-of-the-literature
#19
Eric S Schwenk, Alexander E Grant, Marc C Torjman, Stephen E McNulty, Jaime L Baratta, Eugene R Viscusi
Opioid-induced constipation has a negative impact on quality of life for patients with chronic pain and can affect more than a third of patients. A related but separate entity is postoperative ileus, which is an abnormal pattern of gastrointestinal motility after surgery. Nonselective μ-opioid receptor antagonists reverse constipation and opioid-induced ileus but cross the blood-brain barrier and may reverse analgesia. Peripherally acting μ-opioid receptor antagonists target the μ-opioid receptor without reversing analgesia...
November 2017: Regional Anesthesia and Pain Medicine
https://www.readbyqxmd.com/read/28991118/truncated-%C3%AE-opioid-receptors-with-6-transmembrane-domains-are-essential-for-opioid-analgesia
#20
Zhigang Lu, Jin Xu, Mingming Xu, Grace C Rossi, Susruta Majumdar, Gavril W Pasternak, Ying-Xian Pan
BACKGROUND: Most clinical opioids act through μ-opioid receptors. They effectively relieve pain but are limited by side effects, such as constipation, respiratory depression, dependence, and addiction. Many efforts have been made toward developing potent analgesics that lack side effects. Three-iodobenzoyl-6β-naltrexamide (IBNtxA) is a novel class of opioid active against thermal, inflammatory, and neuropathic pain, without respiratory depression, physical dependence, and reward behavior...
October 4, 2017: Anesthesia and Analgesia
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