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Opioid constipation

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https://www.readbyqxmd.com/read/29451835/characteristics-and-outcomes-of-advanced-cancer-patients-who-received-palliative-care-at-a-public-hospital-compared-with-those-at-a-comprehensive-cancer-center
#1
Marvin Omar Delgado-Guay, Jeannette Ferrer, Jewel Ochoa, Hilda Cantu, Janet L Williams, Minjeong Park, Eduardo Bruera
BACKGROUND: Patients with advanced cancer experience severe physical, psychosocial, and spiritual distress requiring palliative care (PC). There are limited literature regarding characteristics and outcomes of patients evaluated by PC services at public hospitals (PHs). Objective, Design, Setting/Subjects, and Measurements: To compare the outcomes of advanced cancer patients undergoing PC at a PH and those at a comprehensive cancer center (CCC). We reviewed 359 consecutive advanced cancer patients (PH, 180; CCC, 179) undergoing PC...
February 16, 2018: Journal of Palliative Medicine
https://www.readbyqxmd.com/read/29440818/ultrasound-guided-real-time-pterygopalatine-block-for-analgesia-in-an-oral-cancer-patient
#2
Nishkarsh Gupta, Rohini Dattatri, Sachidanand Jee Bharati, Sushma Bhatnagar
Oral cancers are one of the most common cancers in India. These patients have pain during the course of the disease. Various drugs including opioid and nonsteroidal anti-inflammatory drug have been used to manage pain. However, these are associated with side effects such as constipation and vomiting. An early interventional block may decrease the requirement for analgesics and improve the overall quality of life. We describe a case of oral carcinoma successfully managed with ultrasound-guided pterygopalatine block...
January 2018: Indian Journal of Palliative Care
https://www.readbyqxmd.com/read/29436433/updates-in-palliative-care-recent-advancements-in-the-pharmacological-management-of-symptoms
#3
Angela Star, Jason W Boland
Symptom management is an important part of both palliative care and end-of-life care. This article will examine the recent research evidence about drugs commonly used for symptom management in adult patients receiving palliative care. In particular, the management of symptoms where recent palliative care-based evidence has changed recommended practice will be reviewed. This includes: breathlessness, delirium, nausea and vomiting in bowel obstruction, opioid-induced constipation and upper respiratory tract secretions...
February 2018: Clinical Medicine: Journal of the Royal College of Physicians of London
https://www.readbyqxmd.com/read/29432808/the-impact-of-naloxegol-on-anal-sphincter-function-using-a-human-experimental-model-of-opioid-induced-bowel-dysfunction
#4
Debbie Grønlund, Jakob L Poulsen, Klaus Krogh, Christina Brock, Donghua Liao, Hans Gregersen, Asbjørn M Drewes, Anne E Olesen
BACKGROUND AND AIMS: Opioid treatment interferes with anal sphincter function and its regulation during defecation. This may result in straining, incomplete evacuation, and contribute to opioid-induced bowel dysfunction (OIBD). Employing an experimental model of oxycodone-induced OIBD, we hypothesized that co-administration of the peripherally acting μ-opioid antagonist naloxegol would improve anal sphincter function in comparison to placebo. METHODS: In a double-blind randomized crossover trial, 24 healthy males were assigned to a six-day treatment of oral oxycodone 15 mg twice daily in combination with either oral naloxegol 25 mg once daily or placebo...
February 9, 2018: European Journal of Pharmaceutical Sciences
https://www.readbyqxmd.com/read/29420795/the-burden-of-opioid-induced-constipation-in-younger-patients-with-chronic-noncancer-pain
#5
Anita Gupta, Karin S Coyne, Catherine Datto, Christine Venuti
Objective: The purpose of this analysis was to evaluate the experience of opioid-induced constipation in younger patients and identify differences in the experience of opioid-induced constipation and its symptoms between younger patients (<50 years) and older patients (50-64 years). Design: Post hoc analysis of data from a 24-week prospective, multinational, longitudinal observational cohort study (NCT01928953). Setting: Outpatient clinics in the United States, Canada, Germany, and United Kingdom...
February 6, 2018: Pain Medicine: the Official Journal of the American Academy of Pain Medicine
https://www.readbyqxmd.com/read/29419653/long-term-use-of-naldemedine-in-the-treatment-of-opioid-induced-constipation-in-patients-with-chronic-non-cancer-pain-a-randomized-double-blind-placebo-controlled-phase-3-study
#6
Lynn R Webster, Srinivas Nalamachu, Bart Morlion, Jyotsna Reddy, Yuko Baba, Tadaaki Yamada, Juan Camilo Arjona Ferreira
The long-term safety of naldemedine, a peripherally acting µ-opioid receptor antagonist, was evaluated in patients with opioid-induced constipation and chronic non-cancer pain in a 52-week, randomized, double-blind, phase 3 study. Eligible adults who could be on a routine laxative regimen were randomized 1:1 to receive once-daily oral naldemedine 0.2 mg (n = 623) or placebo (n = 623). The primary endpoint was summary measures of treatment-emergent adverse events (AEs). Additional endpoints included opioid withdrawal on the Clinical Opiate Withdrawal Scale and the Subjective Opiate Withdrawal Scale, pain intensity on Numeric Rating Scale, frequency of bowel movements, and constipation-related symptoms and quality of life on the Patient Assessment of Constipation Symptoms and Patient Assessment of Constipation Quality of Life scales, respectively...
February 6, 2018: Pain
https://www.readbyqxmd.com/read/29416370/prolonged-release-oxycodone-naloxone-reduces-opioid-induced-constipation-and-improves-quality-of-life-in-laxative-refractory-patients-results-of-an-observational-study
#7
Carsten Bantel, Shiva S Tripathi, David Molony, Tony Heffernan, Susmita Oomman, Vivek Mehta, Sara Dickerson
Background: Opioids are an effective treatment for moderate-to-severe pain. However, they are associated with a number of gastrointestinal side effects, most commonly constipation. Laxatives do not target the underlying mechanism of opioid-induced constipation (OIC), so many patients do not have their symptoms resolved. Fixed-dose prolonged-release (PR) oxycodone/naloxone (OXN) tablets contain the opioid agonist oxycodone and the opioid antagonist naloxone. Nal-oxone blocks the action of oxycodone in the gut without compromising its analgesic effects...
2018: Clinical and Experimental Gastroenterology
https://www.readbyqxmd.com/read/29406801/randomized-phase-iii-and-extension-studies-of-naldemedine-in-patients-with-opioid-induced-constipation-and-cancer
#8
Yukako Yagi, Kazuhiro Kosugi, Tetsuya Tanimoto
No abstract text is available yet for this article.
February 6, 2018: Journal of Clinical Oncology: Official Journal of the American Society of Clinical Oncology
https://www.readbyqxmd.com/read/29405492/effects-of-naloxegol-on-whole-gut-transit-in-opioid-na%C3%A3-ve-healthy-subjects-receiving-codeine-a-randomized-controlled-trial
#9
H Halawi, P Vijayvargiya, I Busciglio, I Oduyebo, D Khemani, M Ryks, D Rhoten, D Burton, L A Szarka, A Acosta, M Camilleri
BACKGROUND: Nausea, vomiting, and constipation (OIC) are common adverse effects of acute or chronic opioid use. Naloxegol (25 mg) is an approved peripherally active mu-opiate opioid receptor antagonist. AIM: To compare the effects on pan-gut transit of treatment with codeine, naloxegol, or combination in healthy volunteers. METHODS: We conducted a randomized, double-blind, placebo-controlled, single-center, parallel-group study in 72 healthy opioid-naïve adults, randomized to: codeine (30 mg q...
February 6, 2018: Neurogastroenterology and Motility: the Official Journal of the European Gastrointestinal Motility Society
https://www.readbyqxmd.com/read/29391826/spotlight-on-naldemedine-in-the-treatment-of-opioid-induced-constipation-in-adult-patients-with-chronic-noncancer-pain-design-development-and-place-in-therapy
#10
REVIEW
Emily K Stern, Darren M Brenner
Opioid-induced constipation (OIC) is an increasingly prevalent problem in the USA due to the growing use of opioids. A novel class of therapeutics, the peripherally acting μ-opioid receptor antagonists (PAMORAs), has been developed to mitigate the deleterious effects of opioids in the gastrointestinal tract while maintaining central analgesia and minimizing opioid withdrawal. This review aimed to summarize the literature on naldemedine, the third PAMORA to gain US Food and Drug Administration (FDA) approval for the treatment of OIC in adults with chronic noncancer pain-related syndromes...
2018: Journal of Pain Research
https://www.readbyqxmd.com/read/29391822/post-marketing-surveillance-study-of-the-safety-and-efficacy-of-nalfurafine-hydrochloride-remitch%C3%A2-capsules-2-5-%C3%AE-g-in-3-762-hemodialysis-patients-with-intractable-pruritus
#11
Hideki Kozono, Hiroshi Yoshitani, Ryoko Nakano
Background: Intractable pruritus in hemodialysis patients can significantly decrease their quality of life and is also associated with poor vital prognosis. Although combined multiple causes of intractable pruritus in these patients have been identified, no existing treatments are proven to be sufficiently effective. We conducted a post-marketing surveillance to follow-up and assess the safety and efficacy of nalfurafine, a selective κ-opioid receptor agonist, for the treatment of intractable pruritus in patients undergoing hemodialysis...
2018: International Journal of Nephrology and Renovascular Disease
https://www.readbyqxmd.com/read/29377376/cost-effectiveness-of-intravenous-acetaminophen-and-ketorolac-in-adolescents-undergoing-idiopathic-scoliosis-surgery
#12
Vidya Chidambaran, Rajeev Subramanyam, Lili Ding, Senthilkumar Sadhasivam, Kristie Geisler, Bobbie Stubbeman, Peter Sturm, Viral Jain, Mark H Eckman
BACKGROUND: Enhanced recovery after surgery protocols increasingly use multimodal analgesia after major surgeries with intravenous acetaminophen and ketorolac, despite no documented cost-effectiveness of these strategies. AIMS: The goal of this prospective cohort study was to model cost-effectiveness of adding acetaminophen or acetaminophen + ketorolac to opioids for postoperative outcomes in children having scoliosis surgery. METHODS: Of 106 postsurgical children, 36 received only opioids, 26 received intravenous acetaminophen, and 44 received acetaminophen + ketorolac as analgesia adjuncts...
January 29, 2018: Paediatric Anaesthesia
https://www.readbyqxmd.com/read/29374616/efficacy-of-treatments-for-opioid-induced-constipation-a-systematic-review-and-meta-analysis
#13
REVIEW
Judy Nee, Mohammed Zakari, Michael A Sugarman, Julia Whelan, William Hirsch, Shahnaz Sultan, Sarah Ballou, Johanna Iturrino, Anthony Lembo
BACKGROUND & AIMS: Opioid induced constipation (OIC) is a common problem in patients on chronic opioid therapy for cancer-related and non-cancer related pain. Approved treatments for OIC are methylnaltrexone, naloxone, naloxegol, alvimopan, naldemedine, and lubiprostone. Since a meta-analysis performed in 2014, 2 new agents have been approved by the Food and Drug Administration (FDA) for treatment of OIC (naloxegol and naldemedine). METHODS: We conducted a search of the medical literature following the protocol outlined in the Cochrane Handbook for systematic review...
January 25, 2018: Clinical Gastroenterology and Hepatology
https://www.readbyqxmd.com/read/29322659/integrating-dose-estimation-into-a-decision-making-framework-for-model-based-drug-development
#14
James Dunyak, Patrick Mitchell, Bengt Hamrén, Gabriel Helmlinger, James Matcham, Donald Stanski, Nidal Al-Huniti
Model-informed drug discovery and development offers the promise of more efficient clinical development, with increased productivity and reduced cost through scientific decision making and risk management. Go/no-go development decisions in the pharmaceutical industry are often driven by effect size estimates, with the goal of meeting commercially generated target profiles. Sufficient efficacy is critical for eventual success, but the decision to advance development phase is also dependent on adequate knowledge of appropriate dose and dose-response...
January 10, 2018: Pharmaceutical Statistics
https://www.readbyqxmd.com/read/29273520/progress-in-understanding-mechanisms-of-opioid-induced-gastrointestinal-adverse-effects-and-respiratory-depression
#15
REVIEW
Mohammad Zafar Imam, Andy Kuo, Sussan Ghassabian, Maree T Smith
Opioids evoke analgesia through activation of opioid receptors (predominantly the μ opioid receptor) in the central nervous system. Opioid receptors are abundant in multiple regions of the central nervous system and the peripheral nervous system including enteric neurons. Opioid-related adverse effects such as constipation, nausea, and vomiting pose challenges for compliance and continuation of the therapy for chronic pain management. In the post-operative setting opioid-induced depression of respiration can be fatal...
December 20, 2017: Neuropharmacology
https://www.readbyqxmd.com/read/29260692/-faecal-impaction-in-elderly-patients-is-a-potential-severe-condition
#16
Søren Kabell Nissen, Morten Roos Stenberg, Jesper Ryg
This case report presents an old hemiparetic male admitted to hospital from nursing home due to dark-coloured emesis. Transdermal buprenorphine 5 mcg/h had been instigated without laxatives in the preceding month. Upon arrival, an enlarged tense abdomen was found. A CT-scan dem-on-strated a 19 cm wide faecal colon impaction. Limited effect of enemas and endoscopic disimpaction resulted in surgery. The patient died shortly after discharge. The case stresses the prevention of constipation when using opioids; in particular in immobilized patients...
December 18, 2017: Ugeskrift for Laeger
https://www.readbyqxmd.com/read/29243034/application-of-pyridostigmine-in-pediatric-gastrointestinal-motility-disorders-a-case-series
#17
Mhd Louai Manini, Michael Camilleri, Rayna Grothe, Carlo Di Lorenzo
BACKGROUND: Gastrointestinal (GI) motility disorders are common in children. Treatment is challenging with limited medical and surgical options. Pyridostigmine, an acetyl cholinesterase inhibitor, increases acetylcholine at the neuromuscular junction promoting intestinal contractions. Little is known about the role and dosing of pyridostigmine in pediatric GI motility disorders. METHODS: We present a case series of children with GI dysmotility managed with oral pyridostigmine...
December 14, 2017: Paediatric Drugs
https://www.readbyqxmd.com/read/29239347/chronic-constipation
#18
REVIEW
Michael Camilleri, Alexander C Ford, Gary M Mawe, Phil G Dinning, Satish S Rao, William D Chey, Magnus Simrén, Anthony Lembo, Tonia M Young-Fadok, Lin Chang
Chronic constipation is a prevalent condition that severely impacts the quality of life of those affected. Several types of primary chronic constipation, which show substantial overlap, have been described, including normal-transit constipation, rectal evacuation disorders and slow-transit constipation. Diagnosis of primary chronic constipation involves a multistep process initiated by the exclusion of 'alarm' features (for example, unintentional weight loss or rectal bleeding) that might indicate organic diseases (such as polyps or tumours) and a therapeutic trial with first-line treatments such as dietary changes, lifestyle modifications and over-the-counter laxatives...
December 14, 2017: Nature Reviews. Disease Primers
https://www.readbyqxmd.com/read/29232630/opioid-drugs-and-stercoral-perforation-of-the-colon-case-report-and-review-of-literature
#19
Renée Poitras, Daun'Lee Warren, Sylvanus Oyogoa
INTRODUCTION: Stercoral perforation of the colon is a rare pathology, which is believed to be caused by an increased intraluminal pressure created by a fecaloma. Opioid induced constipation is a rare and often unsuspected cause of colonic perforation. PRESENTATION OF CASE: We report the case of a 58-year-old woman, who presented to the emergency department (ED) with severe hypotension, abdominal pain and gastrointestinal bleeding. She was found to have a diffusely tender and distended abdomen...
December 7, 2017: International Journal of Surgery Case Reports
https://www.readbyqxmd.com/read/29220110/non-responsiveness-and-susceptibility-of-opioids-side-effects-related-to-cancer-patients-clinical-characteristics-a-post-hoc-analysis
#20
Oscar Corli, Anna Roberto, Michael I Bennett, Francesca Galli, Nicole Corsi, Eliana Rulli, Raffaella Antonione
BACKGROUND: Response to opioids is not always positive in cancer patients. A considerable proportion of patients do not respond (non-responders, NRs) or experience severe toxicity. The aim of this analysis was to assess the role of demographic characteristics, pain features, comorbidities and ongoing therapy on the lack of efficacy and on the occurrence of severe adverse drug reactions (ADRs). METHODS: This is a post-hoc analysis of a randomized controlled trial that involved 520 patients and was aimed to evaluate the efficacy and safety of four strong opioids...
December 8, 2017: Pain Practice: the Official Journal of World Institute of Pain
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