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Opioid constipation

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https://www.readbyqxmd.com/read/28059433/a-12-week-extension-study-to-assess-the-safety-and-tolerability-of-naloxegol-in-patients-with-noncancer-pain-and-opioid-induced-constipation
#1
Lynn Webster, Raj Tummala, Ulysses Diva, Jaakko Lappalainen
OBJECTIVE: To compare the long-term safety and tolerability of naloxegol with placebo in patients with opioid-induced constipation (OIC) and noncancer pain. DESIGN: Twelve-week, multicenter, randomized, double-blind, parallel-group phase 3 extension study (KODIAC-07, NCT01395524). SETTING: Clinical investigation centers in the United States. PATIENTS: Adult outpatients (N = 302) with confirmed OIC who had completed a 12-week pivotal phase 3 study (KODIAC-04, NCT01309841)...
November 2016: Journal of Opioid Management
https://www.readbyqxmd.com/read/28053617/characterization-the-response-of-korl-icr-mice-to-loperamide-induced-constipation
#2
Ji Eun Kim, Woo Bin Yun, Ji Eun Sung, Hyun Ah Lee, Jun Young Choi, Yeon Shik Choi, Young Suk Jung, Kil Soo Kim, Dae Youn Hwang
Animal models of constipation induced with drugs and diet have been widely employed to investigate therapeutic effects and the action mechanism of drugs against this disease. ICR mice were selected to produce this disease model through oral administration of loperamide (Lop), even though SD rats are commonly utilized in studies of constipation. To compare the responses of ICR mice obtained from three different sources to constipation inducers, alterations in stool number, histopathological structure, mucin secretion and opioid-receptor downstream signaling pathway were measured in Korl:ICR (Korea FDA source), A:ICR (USA source) and B:ICR (Japan source) injected with low and high concentrations of Lop (LoLop and HiLop)...
December 2016: Laboratory Animal Research
https://www.readbyqxmd.com/read/28035588/clinical-pharmacokinetics-and-pharmacodynamics-of-naloxegol-a-peripherally-acting-%C3%A2%C2%B5-opioid-receptor-antagonist
#3
REVIEW
Khanh Bui, Diansong Zhou, Hongmei Xu, Eike Floettmann, Nidal Al-Huniti
Naloxegol is a peripherally acting µ-opioid receptor antagonist approved for use as an orally administered tablet (therapeutic doses of 12.5 and 25 mg) for the treatment of opioid-induced constipation. Over a wide dose range (i.e. single supratherapeutic doses up to 1000 mg in healthy volunteers), the pharmacokinetic properties of naloxegol appear to be time- and dose-independent. Naloxegol is rapidly absorbed, with mean time to maximum plasma concentration of <2 h. Following once-daily administration, steady state is achieved within 2-3 days and minimal accumulation is observed...
December 29, 2016: Clinical Pharmacokinetics
https://www.readbyqxmd.com/read/28034973/opioid-induced-constipation-and-bowel-dysfunction-a-clinical-guideline
#4
Stefan Müller-Lissner, Gabrio Bassotti, Benoit Coffin, Asbjørn Mohr Drewes, Harald Breivik, Elon Eisenberg, Anton Emmanuel, Françoise Laroche, Winfried Meissner, Bart Morlion
OBJECTIVE:  To formulate timely evidence-based guidelines for the management of opioid-induced bowel dysfunction. SETTING:  Constipation is a major untoward effect of opioids. Increasing prescription of opioids has correlated to increased incidence of opioid-induced constipation. However, the inhibitory effects of opioids are not confined to the colon, but also affect higher segments of the gastrointestinal tract, leading to the coining of the term "opioid-induced bowel dysfunction...
December 29, 2016: Pain Medicine: the Official Journal of the American Academy of Pain Medicine
https://www.readbyqxmd.com/read/28024664/long-term-use-of-opioids-in-210-officially-registered-patients-with-chronic-noncancer-pain-in-taiwan-a-cross-sectional-study
#5
Tso-Chou Lin, Luo-Ping Ger, Joseph V Pergolizzi, Robert B Raffa, Ju-O Wang, Shung-Tai Ho
BACKGROUND/PURPOSE: Prescribing opioids for chronic noncancer pain has been strictly regulated for two decades in Taiwan. The aim of this study was to survey the patients' perspectives and potential drawbacks following long-term use of opioids. METHODS: An observational cross-sectional survey using the Taiwanese version of Brief Pain Inventory was conducted among outpatients with chronic noncancer pain registered by the Taiwan Food and Drug Administration. Patients were also asked about their sexual behavior, depression, opioid misuse behaviors, and use of complementary and alternative medicine...
December 23, 2016: Journal of the Formosan Medical Association, Taiwan Yi Zhi
https://www.readbyqxmd.com/read/28019066/opioid-analgesic-use-among-patients-presenting-with-acute-abdominal-pain-and-factors-associated-with-surgical-diagnoses
#6
D Khemani, M Camilleri, A Roldan, A D Nelson, S-Y Park, A Acosta, A R Zinsmeister
BACKGROUND: The prevalence of chronic opioid use among non-cancer patients presenting with acute abdominal pain (AAP) is unknown. The aim was to characterize opioid use, constipation, diagnoses, and risk factors for surgical diagnoses among non-cancer patients presenting with AAP to an emergency department (ED). METHODS: We performed a retrospective, observational cohort study of all (n=16,121) adult patients (88% from MN, IA and WI) presenting during 2014 with AAP...
December 25, 2016: Neurogastroenterology and Motility: the Official Journal of the European Gastrointestinal Motility Society
https://www.readbyqxmd.com/read/28000181/-application-of-roman-iiii-criteria-in-the-diagnosis-of-chronic-constipation
#7
Xiucai Fang
In Rome IIII( diagnostic system, disorders associated with chronic constipation include functional constipation, opioid-induced constipation, irritable bowel syndrome with predominant constipation and functional defecation disorders, each disorder has the relative characteristics of clinical manifestations and underlying pathophysiology. Rome IIII( committee modified the diagnostic criteria based on current research achievements, and recommended to make the diagnosis of functional constipation disorders with minimal laboratory test and with indications for colonoscopy and pathophysiological tests...
December 25, 2016: Zhonghua Wei Chang Wai Ke za Zhi, Chinese Journal of Gastrointestinal Surgery
https://www.readbyqxmd.com/read/27981871/reliability-and-validity-of-the-bowel-function-index-bfi-for-evaluating-opioid-induced-constipation-translation-cultural-adaptation-and-validation-of-the-portuguese-version-bfi-p
#8
María Dueñas, Liliane Mendonça, Rute Sampaio, Cláudia Gouvinhas, Daniela Oliveira, José Manuel Castro-Lopes, Luís Filipe Azevedo
OBJECTIVE: The Bowel Function Index (BFI) is a simple and sound measure of bowel function and opioid-induced constipation (OIC) screening tool. We aimed to develop the translation and cultural adaptation of this measure (BFI-P) and to assess its reliability and validity for the Portuguese language and a chronic pain population. METHODS: The BFI-P was created after a process including translation, back translation and cultural adaptation. Participants (n = 226) were recruited in a Chronic Pain Clinic and were assessed at baseline and after one week...
December 16, 2016: Current Medical Research and Opinion
https://www.readbyqxmd.com/read/27938897/translating-clinical-findings-into-the-patient-s-perspective-post-hoc-pooled-analysis-of-bowel-movement-changes-as-a-predictor-of-improvement-in-patients-opioid-induced-constipation-symptoms-and-outcomes
#9
Karin S Coyne, Jiat-Ling Poon, Christine Thompson, Yiqun Hu, Catherine J Datto, Mark Sostek
PURPOSE: Opioid-induced constipation (OIC) is a bothersome side effect of opioid use for the management of noncancer pain, affecting patients' health-related quality of life and chronic-pain management. The objective of this study was to examine the relationship between changes in the frequency of spontaneous bowel movements (SBMs) and changes in patient-reported outcomes (PROs) among patients with OIC treated with naloxegol. METHODS: Post hoc analyses were conducted using pooled data from two Phase III 12-week, placebo-controlled trials of naloxegol for the treatment of OIC (NCT01309841 and NCT01323790)...
December 6, 2016: Clinical Therapeutics
https://www.readbyqxmd.com/read/27929709/safety-of-buprenorphine-transdermal-system-in-the-management-of-pain-in-older-adults
#10
Joseph V Pergolizzi, Robert B Raffa, Zachary Marcum, Salvatore Colucci, Steven R Ripa
OBJECTIVES: To evaluate whether buprenorphine transdermal system (BTDS; Butrans®) is an option for the treatment of chronic pain in older adults. METHODS: This retrospective analysis of 16 placebo- and active-controlled and uncontrolled studies (N = 6566) evaluated the safety and tolerability profile in patients exposed to BTDS and compared the safety profiles associated with BTDS treatment in older patients ≥ 65 years of age (65 to 98 years) and younger patients < 65 years of age (18 to 64 years)...
December 26, 2016: Postgraduate Medicine
https://www.readbyqxmd.com/read/27922029/safety-of-eluxadoline-in-patients-with-irritable-bowel-syndrome-with-diarrhea
#11
Brooks D Cash, Brian E Lacy, Philip S Schoenfeld, Leonard S Dove, Paul S Covington
OBJECTIVES: Eluxadoline is a mixed μ-opioid receptor (OR) and κ-OR agonist and δ-OR antagonist, approved for the treatment of irritable bowel syndrome with diarrhea (IBS-D). This analysis evaluated the safety and tolerability of eluxadoline 75 and 100 mg twice daily (BID) in one Phase 2 (IBS-2001) and two Phase 3 (IBS-3001 and IBS-3002) studies. METHODS: Adults with IBS-D (Rome III criteria) were randomized to placebo or eluxadoline (75 or 100 mg) BID for 12 (IBS-2001), 26 (IBS-3002), or 52 (IBS-3001) weeks...
December 6, 2016: American Journal of Gastroenterology
https://www.readbyqxmd.com/read/27921252/opioid-induced-bowel-dysfunction-in-patients-undergoing-spine-surgery-comparison-of-oxycodone-and-oxycodone-naloxone-treatment
#12
Merja Kokki, Moona Kuronen, Toivo Naaranlahti, Timo Nyyssönen, Ira Pikkarainen, Sakari Savolainen, Hannu Kokki
INTRODUCTION: Opioids are needed for postoperative pain in spine surgery patients, but opioid-induced constipation is a harmful adverse event. The aim of this clinical trial was to compare the use of a controlled-release oxycodone-naloxone combination product with oxycodone controlled-release tablets in these patients. The main outcome measure was the prevalence of constipation at 7 days postoperatively assessed with a Bowel Function Index questionnaire. A follow-up assessment at 21 days after surgery was also included...
December 5, 2016: Advances in Therapy
https://www.readbyqxmd.com/read/27875419/new-treatment-options-for-irritable-bowel-syndrome-with-predominant-diarrhea
#13
H Christian Weber
PURPOSE OF REVIEW: Irritable bowel syndrome (IBS) is a highly prevalent gastrointestinal disorder with negative impact on quality of life and it represents a substantial economic burden on healthcare cost. The medical management of IBS remains largely symptomatic. This review provides an update related to the most recently published diagnostic Rome IV criteria for IBS and clinical trial data for novel treatment modalities in IBS targeting the peripheral opioid receptors of the enteric nervous system and the gut microbiota...
February 2017: Current Opinion in Endocrinology, Diabetes, and Obesity
https://www.readbyqxmd.com/read/27860208/randomized-double-blind-trial-of-oral-methylnaltrexone-for-the-treatment-of-opioid-induced-constipation-in-patients-with-chronic-noncancer-pain
#14
Richard Rauck, Neal E Slatkin, Nancy Stambler, Joseph R Harper, Robert J Israel
BACKGROUND: Subcutaneous methylnaltrexone, a peripherally acting μ-opioid receptor antagonist, improves opioid-induced constipation (OIC) in patients with chronic noncancer pain. An oral methylnaltrexone formulation has been developed. METHODS: In this phase 3, double-blind trial, adults with chronic noncancer pain receiving opioid doses of ≥50 mg/d oral morphine equivalents with OIC were randomly assigned to oral methylnaltrexone (150 mg, 300 mg, or 450 mg) or placebo once daily (QD) for 4 weeks followed by as-needed dosing for 8 weeks...
November 17, 2016: Pain Practice: the Official Journal of World Institute of Pain
https://www.readbyqxmd.com/read/27832472/oxycodone-deterx-%C3%A2-er-capsules-a-review-in-severe-chronic-pain
#15
Yvette N Lamb, Karly P Garnock-Jones, Susan J Keam
Oxycodone DETERx (®) extended-release (ER) capsules (Xtampza(®) ER), an abuse-deterrent formulation of oxycodone as the myristate salt, are approved in the USA for the management of pain severe enough to require daily, around-the-clock, long-term opioid treatment and for which alternative treatment options are inadequate. This narrative review discusses the clinical efficacy and tolerability of the oxycodone DETERx (®) ER capsule formulation in the management of severe pain, and provides an overview of pharmacokinetics, abuse-deterrent properties and alternative administration options...
December 2016: Drugs
https://www.readbyqxmd.com/read/27830531/treatment-of-severe-pain-and-opioid-induced-constipation-an-observational-study-of-quality-of-life-resource-use-and-costs-in-sweden
#16
Frida Hjalte, Gunnel Ragnarson Tennvall, Karl-Olof Welin, Dagmar Westerling
INTRODUCTION: Opioid-induced constipation (OIC) is a common and costly side effect of opioid treatment affecting patients' quality of life (QoL). The combination oxycodone/naloxone reduces OIC while providing effective analgesia in patients with moderate to severe pain. The objective of this observational study was to compare health-related quality of life (HRQoL), healthcare resource use, and costs in patients with severe pain who were initially treated with oxycodone and laxatives and then subsequently switched to treatment with oxycodone/naloxone...
December 2016: Pain and Therapy
https://www.readbyqxmd.com/read/27826213/management-of-moderate-to-severe-chronic-low-back-pain-with-buprenorphine-buccal-film-using-novel-bioerodible-mucoadhesive-technology
#17
REVIEW
Joseph V Pergolizzi, Robert B Raffa, Charles Fleischer, Gianpietro Zampogna, Robert Taylor
With a global prevalence of ~9%-12%, low back pain (LBP) is a serious public health issue, associated with high costs for treatment and lost productivity. Chronic LBP (cLBP) involves central sensitization, a neuropathic pain component, and may induce maladaptive coping strategies and depression. Treating cLBP is challenging, and current treatment options are not fully satisfactory. A new BioErodible MucoAdhesive (BEMA(®)) delivery system for buprenorphine has been developed to treat cLBP. The buccal buprenorphine (BBUP) film developed for this product (Belbuca™) allows for rapid delivery and titration over a greater range of doses than was previously available with transdermal buprenorphine systems...
2016: Journal of Pain Research
https://www.readbyqxmd.com/read/27815136/phenylquinoxalinone-cftr-activator-as-potential-prosecretory-therapy-for-constipation
#18
Onur Cil, Puay-Wah Phuan, Jung-Ho Son, Jie S Zhu, Colton K Ku, Niloufar Akhavan Tabib, Andrew P Teuthorn, Loretta Ferrera, Nicholas C Zachos, Ruxian Lin, Luis J V Galietta, Mark Donowitz, Mark J Kurth, A S Verkman
Constipation is a common condition for which current treatments can have limited efficacy. By high-throughput screening, we recently identified a phenylquinoxalinone activator of the cystic fibrosis transmembrane conductance regulator (CFTR) chloride channel that stimulated intestinal fluid secretion and normalized stool output in a mouse model of opioid-induced constipation (Cil et al Cell Mol Gastroenterol Hepatol 2:317-327, 2016). Here, we report phenylquinoxalinone structure-activity analysis, mechanism of action, animal efficacy data in acute and chronic models of constipation, and functional data in ex vivo primary cultured human enterocytes...
October 15, 2016: Translational Research: the Journal of Laboratory and Clinical Medicine
https://www.readbyqxmd.com/read/27807793/opioids-and-gi-motility-friend-or-foe
#19
REVIEW
Allen A Lee, William L Hasler
The use of opioids for the treatment of chronic non-cancer pain is growing at an alarming rate. Opioid-induced bowel dysfunction (OBD) is a common adverse effect of long-term opioid treatment manifesting as constipation, nausea, and vomiting. These effects are primarily mediated by peripheral μ-opioid receptors with resultant altered GI motility and function. As a result, patients may present with opioid-induced constipation (OIC), opioid-induced nausea and vomiting (OINV), and/or narcotic bowel syndrome (NBS)...
November 2, 2016: Current Treatment Options in Gastroenterology
https://www.readbyqxmd.com/read/27803072/factors-associated-with-the-prophylactic-prescription-of-a-bowel-regimen-to-prevent-opioid-induced-constipation
#20
Nancy Y Chen, Eugene Nguyen, Sheree M Schrager, Christopher J Russell
OBJECTIVE: Identify factors associated with the prophylactic prescription of a bowel regimen with an inpatient opioid prescription. METHODS: This was a retrospective cohort study from June 1, 2013, to October 31, 2014 of pediatric inpatients prescribed an oral or intravenous opioid on the general medical/surgical floors. We identified patients with or without a prophylactic prescription of a bowel regimen. We obtained patient demographics, prescriber training level and service and used multivariate logistic regression to analyze the factors associated with prophylactic bowel regimen and opioid prescription...
November 2016: Hospital Pediatrics
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