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Opioid constipation

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https://www.readbyqxmd.com/read/28919810/a-comparison-between-the-administration-of-oral-prolonged-release-oxycodone-naloxone-and-transdermal-fentanyl-in-patients-with-moderate-to-severe-cancer-pain-a-propensity-score-analysis
#1
A Roberto, M T Greco, L Legramandi, F Galli, M Galli, O Corli
BACKGROUND: Opioids are the most important pharmacological treatment for moderate-to-severe cancer pain, but side effects limit their use. Transdermal fentanyl (TDF) and oral prolonged-release oxycodone-naloxone (OXN-PR) are effective in controlling chronic pain, with less constipation compared to other opioids. However, TDF and OXN-PR have never been directly compared. PATIENTS AND METHODS: Cancer patients with moderate-to-severe chronic pain were consecutively enrolled in two prospective 28-day trials, received either TDF or OXN-PR, and were assessed at baseline and after 7, 14, 21, and 28 days...
2017: Journal of Pain Research
https://www.readbyqxmd.com/read/28919541/drugs-for-treating-opioid-induced-constipation-a-mixed-treatment-comparison-network-meta-analysis-of-randomized-controlled-clinical-trials
#2
Kannan Sridharan, Gowri Sivaramakrishnan
CONTEXT: Opioid-induced constipation is a common problem associated with chronic use of opioid analgesics. OBJECTIVES: To compare available interventions for the treatment of opioid-induced constipation, using principles of network meta-analysis. METHODS: Electronic databases were searched for randomized controlled clinical trials evaluating drugs used in opioid induced constipation. Number of patients with rescue-free bowel movements (RFBM) was the primary outcome and time for achieving RFBM, adverse events and changes in the analgesic activity of the opioid analgesics were the secondary outcomes...
September 14, 2017: Journal of Pain and Symptom Management
https://www.readbyqxmd.com/read/28906155/the-role-of-tapentadol-as-a-strong-opioid-in-cancer-pain-management-a-systematic-and-critical-review
#3
Sebastiano Mercadante
The aim of this review was to assess the role of tapentadol given at medium-high doses in opioid-tolerant patients for cancer pain management in place of step-3 analgesics. A systematic literature search was performed out of which six studies and one secondary analysis provided data regarding tapentadol used as a step- 3 analgesic for this review. Tapentadol, when used at ≥ 60 mg of oral morphine equivalents in opioid-tolerant patients with cancer pain, or passing from step-2 doses to ≥ 60 mg of oral morphine equivalents, was well tolerated and effective and could be considered as a flexible drug to be used for the management of moderate to severe cancer pain...
September 14, 2017: Current Medical Research and Opinion
https://www.readbyqxmd.com/read/28898536/treatment-with-naloxegol-versus-placebo-pain-assessment-in-patients-with-noncancer-pain-and-opioid-induced-constipation
#4
Lynn Webster, Ulysses Diva, Raj Tummala, Mark Sostek
OBJECTIVE: To summarize results from pain and opioid use assessments with naloxegol in adults with opioid-induced constipation (OIC) and chronic noncancer pain. METHODS: Two phase 3 randomized, double-blind, 12-week studies evaluated the efficacy and safety of oral naloxegol (12.5 or 25 mg daily) in adults (18-<85 years) with confirmed OIC and chronic noncancer pain: KODIAC-04 (NCT01309841) and KODIAC-05 (NCT01323790). Pain level was assessed daily (11-point Numeric Rating Scale [NRS]; 0=no pain, 10=worst imaginable pain)...
September 12, 2017: Pain Practice: the Official Journal of World Institute of Pain
https://www.readbyqxmd.com/read/28893309/efficacy-and-safety-of-controlled-release-oxycodone-naloxone-versus-controlled-release-oxycodone-in-korean-patients-with-cancer-related-pain-a-randomized-controlled-trial
#5
Kyung-Hee Lee, Tae Won Kim, Jung-Hun Kang, Jin-Soo Kim, Jin-Seok Ahn, Sun-Young Kim, Hwan-Jung Yun, Young-Jun Eum, Sung Ae Koh, Min Kyoung Kim, Yong Sang Hong, Jeong Eun Kim, Gyeong-Won Lee
BACKGROUND: Controlled-release oxycodone/naloxone (OXN-CR) maintains the effect of opioid-induced analgesia through oxycodone while reducing the occurrence rate of opioid-induced constipation through naloxone. The present study was designed to assess the non-inferiority of OXN-CR to controlled-release oxycodone (OX-CR) for the control of cancer-related pain in Korean patients. METHODS: In this randomized, open-labeled, parallel-group, phase IV study, we enrolled patients aged 20 years or older with moderate to severe cancer-related pain [numeric rating scale (NRS) pain score ≥4] from seven Korean oncology/hematology centers...
September 11, 2017: Chinese Journal of Cancer
https://www.readbyqxmd.com/read/28860850/a-randomized-double-blind-study-of-hydromorphone-hydrochloride-extended-release-tablets-versus-oxycodone-hydrochloride-extended-release-tablets-for-cancer-pain-efficacy-and-safety-in-japanese-cancer-patients-exheal-a-phase-iii-study-of-extended-release-hydromorphone
#6
Satoshi Inoue, Yoji Saito, Satoru Tsuneto, Etsuko Aruga, Azusa Ide, Yasuyuki Kakurai
BACKGROUND: In Japan, there are limited options for switching opioid analgesics. Hydromorphone is an opioid analgesic that is routinely used instead of morphine for cancer pain; however, it is not yet available in Japan. The aim of this study was to assess the efficacy and safety of hydromorphone (DS-7113b) extended-release tablets in opioid-naïve patients with cancer pain not relieved by non-opioid analgesics. SUBJECTS AND METHODS: This was a multicenter, randomized, double-blind, parallel-group trial...
2017: Journal of Pain Research
https://www.readbyqxmd.com/read/28860712/a-comparison-of-oral-controlled-release-morphine-and-oxycodone-with-transdermal-formulations-of-buprenorphine-and-fentanyl-in-the-treatment-of-severe-pain-in-cancer-patients
#7
Krzysztof Nosek, Wojciech Leppert, Hanna Nosek, Jerzy Wordliczek, Dariusz Onichimowski
AIM OF THE STUDY: To compare analgesia and adverse effects during oral morphine and oxycodone and transdermal fentanyl and buprenorphine administration in cancer patients with pain. PATIENTS AND METHODS: Cancer patients treated at home and in outpatient clinics with severe pain (numerical rating scale score 6-10) fail to respond to non-opioids and/or weak opioids. All patients were randomized to either morphine, oxycodone, fentanyl or buprenorphine and divided into subgroups with predominant neuropathic and nociceptive pain component...
2017: Drug Design, Development and Therapy
https://www.readbyqxmd.com/read/28858018/naloxegol-for-managing-opioid-induced-constipation
#8
Krystal N Shelton, Jennifer N Clements
Naloxegol is a peripherally acting mu-opioid receptor antagonist for opioid-induced constipation in adults with chronic noncancer pain. This drug's once-daily oral formulation can be used as monotherapy and helps to decrease the constipating effects of opioid therapy; however, it has been associated with abdominal pain.
September 2017: JAAPA: Official Journal of the American Academy of Physician Assistants
https://www.readbyqxmd.com/read/28829910/oxycodone-for-cancer-related-pain
#9
REVIEW
Mia Schmidt-Hansen, Michael I Bennett, Stephanie Arnold, Nathan Bromham, Jennifer S Hilgart
BACKGROUND: Many people with cancer experience moderate to severe pain that requires treatment with strong opioids, such as oxycodone and morphine. Strong opioids are, however, not effective for pain in all people, neither are they well-tolerated by all people. The aim of this review was to assess whether oxycodone is associated with better pain relief and tolerability than other analgesic options for adults with cancer pain. This is an updated version of the original Cochrane review published in 2015, Issue 2 on oxycodone for cancer-related pain...
August 22, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/28826680/patient-characteristics-associated-with-quality-of-colonoscopy-preparation-a-systematic-review-and-meta-analysis
#10
Kunjal Gandhi, Christina Tofani, Carly Sokach, Devin Patel, David Kastenberg, Constantine Daskalakis
BACKGROUND & AIMS: Some features of patients are associated with inadequate bowel preparation, which reduces the effectiveness of colonoscopy examination. We performed a systematic review and meta-analysis of the association between patients' sociodemographic characteristics, health conditions, and medications with inadequate bowel preparation. METHODS: We searched the PubMed, Scopus, and Cochrane Review databases for randomized controlled trials and cohort (prospective and retrospective), case-control, and cross-sectional studies published through March 2016...
August 18, 2017: Clinical Gastroenterology and Hepatology
https://www.readbyqxmd.com/read/28820793/codeine-plus-acetaminophen-for-pain-after-photorefractive-keratectomy-a-randomized-double-blind-placebo-controlled-add-on-trial
#11
Vinicius B P Pereira, Renato Garcia, Andre A M Torricelli, Adriana Mukai, Samir J Bechara
BACKGROUND: Pain after photorefractive keratectomy (PRK) is significant, and the analgesic efficacy and safety of oral opioids in combination with acetaminophen has not been fully investigated in PRK trials. PURPOSE: To assess the efficacy and safety of the combination of codeine plus acetaminophen (paracetamol) versus placebo as an add-on therapy for pain control after PRK. STUDY DESIGN: Randomized, double-blind, placebo-controlled trial...
October 2017: Cornea
https://www.readbyqxmd.com/read/28810695/long-term-safety-and-efficacy-of-subcutaneous-methylnaltrexone-in-patients-with-opioid-induced-constipation-and-chronic-noncancer-pain-a-phase-3-open-label-trial
#12
Lynn R Webster, Edward Michna, Arif Khan, Robert J Israel, Joseph R Harper
Objective: Methylnaltrexone, a peripherally acting µ-opioid receptor antagonist, alleviates opioid-induced constipation. Understanding its long-term safety and efficacy profile in patients with chronic noncancer pain is warranted given the persistence of opioid-induced constipation. Methods. : In this phase 3, multicenter, open-label trial, adults with chronic noncancer pain (N = 1034) received subcutaneous methylnaltrexone 12 mg once daily for 48 weeks...
August 1, 2017: Pain Medicine: the Official Journal of the American Academy of Pain Medicine
https://www.readbyqxmd.com/read/28808081/%C3%A2-eluxadoline-for-ibs-d
#13
(no author information available yet)
Irritable bowel syndrome (IBS) is a chronic relapsing gastrointestinal problem characterised by intestinal pain and associated alterations of defecation and/or bowel habit (constipation: IBS-C or diarrhoea: IBS-D).(1,2) Opioid receptors in the gut have a role in gastrointestinal motility, secretion and sensation.(3) Τ Eluxadoline (Truberzi-Allergan) is a locally acting, mixed opioid receptor agonist/antagonist licensed for the treatment of IBS-D in adults.(4) Here, we consider the evidence for eluxadoline and how it fts with current management strategies for IBS-D...
August 2017: Drug and Therapeutics Bulletin
https://www.readbyqxmd.com/read/28805471/prolonged-release-oxycodone-and-naloxone-treatment-counteracts-opioid-induced-constipation-in-patients-with-severe-pain-compared-to-previous-analgesic-treatment
#14
Gineke Koopmans-Klein, Joeri Van Op den Bosch, Yvonne van Megen, Hans Prenen, Frank Huygen, Isabelle Mancini
OBJECTIVE: Treatment with prolonged-release oxycodone/naloxone (PR OXN) has been shown to improve opioid induced constipation (OIC) in constipated patients. This publication reports on a real-life observational study investigating the efficacy of PR OXN with regard to bowel function in patients switching to PR OXN from WHO step 1, step 2 and step 3 opioids. METHODS: Patients with chronic pain experiencing insufficient pain relief and/or unacceptable side effects were switched to PR OXN and monitored in this observational study with respect to efficacy regarding bowel function and efficacy regarding pain relief in comparison with previous analgesic therapy...
September 11, 2017: Current Medical Research and Opinion
https://www.readbyqxmd.com/read/28802093/clinical-aspects-of-opium-adulterated-with-lead-in-iran-a-review
#15
Samira Alinejad, Jan Aaseth, Mohammad Abdollahi, Hossein Hassanian-Moghaddam, Omid Mehrpour
Adulteration of drugs with poisonous substances during production or consumption has caused numerous health problems. Among contaminants that have the potential of producing poisonous effects are the heavy metals lead, arsenic and thallium that make up an important group of toxic substances. The emergence of these new health problems related to opioid abuse has precipitated this MiniReview on the status of the most hazardous and common opioid adulterants. In fact, adulterated opium is a major public health problem and can threaten the health of users...
August 12, 2017: Basic & Clinical Pharmacology & Toxicology
https://www.readbyqxmd.com/read/28796769/medication-related-patient-harm-in-new-zealand-hospitals
#16
MULTICENTER STUDY
Gillian Robb, Elizabeth Loe, Ashika Maharaj, Richard Hamblin, Mary E Seddon
AIM: The purpose of this study is to identify patterns of medication-related harm from a national perspective, and to use this information to inform decisions on where to focus medication safety efforts. This study updates a 2013 study using the same methodology. METHOD: District health boards (DHBs) still actively using either the Adverse Drug Event (ADE) Trigger Tool (TT) or the Global Trigger Tool (GTT), submitted two years of anonymised ADE data (1 July 2013-30 June 2015) to the Health Quality & Safety Commission (the Commission) using a standard template...
August 11, 2017: New Zealand Medical Journal
https://www.readbyqxmd.com/read/28791598/opioid-medications-in-the-management-of-chronic-abdominal-pain
#17
REVIEW
Dajie Wang
PURPOSE OF REVIEW: Chronic abdominal pain is a complex medical condition. The causes of chronic abdominal pain are extremely diverse ranging from chronic pancreatitis, Crohn's disease, to chronic pain with no clear etiology. Treatment of chronic abdominal pain remains a challenge in our clinical practice. While current interventions with celiac plexus blocks and pain medications provide some relief for these patients, but these treatments are typically less efficacious and limited by various adverse effects...
August 8, 2017: Current Pain and Headache Reports
https://www.readbyqxmd.com/read/28782266/population-exposure-response-modeling-supported-selection-of-naloxegol-doses-in-phase-3-studies-in-patients-with-opioid-induced-constipation
#18
Nidal Al-Huniti, Hongmei Xu, Diansong Zhou, Sergey Aksenov, Robert Fox, Khanh H Bui
Naloxegol is approved for the treatment of opioid-induced constipation (OIC) in adults with chronic non-cancer pain. Population exposure-response models were developed using data from a Phase 2 study comprising 185 adults with OIC. The weekly probability of response defined as having ≥3/week spontaneous bowel movements (SBMs) and ≥1 SBM/week increase over baseline was characterized by a longitudinal mixed-effects logistic regression dose-response model, and the probability of time to discontinuation was modeled with a Weibull distribution function...
August 7, 2017: CPT: Pharmacometrics & Systems Pharmacology
https://www.readbyqxmd.com/read/28781502/pharmaceutical-approval-update
#19
Michele B Kaufman
Naldemedine (Symproic) for opioid-induced constipation; deutetrabenazine (Austedo) for chorea associated with Huntington's disease; and infliximab-abda (Renflexis), a Remicade biosimilar, for the treatment of Crohn's disease, rheumatoid arthritis, and other diseases.
August 2017: P & T: a Peer-reviewed Journal for Formulary Management
https://www.readbyqxmd.com/read/28770976/non-steroidal-anti-inflammatory-drugs-nsaids-for-chronic-non-cancer-pain-in-children-and-adolescents
#20
REVIEW
Christopher Eccleston, Tess E Cooper, Emma Fisher, Brian Anderson, Nick Mr Wilkinson
BACKGROUND: Pain is a common feature of childhood and adolescence around the world, and for many young people, that pain is chronic. The World Health Organization guidelines for pharmacological treatments for children's persisting pain acknowledge that pain in children is a major public health concern of high significance in most parts of the world. While in the past pain was largely dismissed and was frequently left untreated, views on children's pain have changed over time, and relief of pain is now seen as important...
August 2, 2017: Cochrane Database of Systematic Reviews
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