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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/29095765/new-therapies-in-irritable-bowel-syndrome-what-works-and-when
#2
Orla Craig
PURPOSE OF REVIEW: The purpose of this review is to examine the evidence supporting the use of recently developed pharmacological treatments for IBS together with new evidence supporting more traditional therapies in order to understand where the new agents are best used in the treatment pathway. RECENT FINDINGS: There is evidence to support the use of traditional treatments such as antispasmodics, antidepressants and dietary alteration in IBS. New therapeutic agents such as Linaclotide, Lubiprostone, Plecanatide, Rifaxamin and Eluxadoline are all more effective than placebo in treating symptoms of IBS with Tenapanor being a promising new agent...
November 1, 2017: Current Opinion in Gastroenterology
https://www.readbyqxmd.com/read/29092627/evidence-based-review-of-pharmacotherapy-for-opioid-induced-constipation-in-noncancer-pain
#3
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/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
#4
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/28965302/analysis-of-nausea-in-clinical-studies-of-lubiprostone-for-the-treatment-of-constipation-disorders
#5
EDITORIAL
Jonathan Gotfried, Ron Schey
No abstract text is available yet for this article.
December 2017: Digestive Diseases and Sciences
https://www.readbyqxmd.com/read/28933338/impact-of-lubiprostone-on-gastric-emptying-profile-and-the-possible-effect-of-concomitant-domperidone-in-healthy-adults%C3%A2
#6
Takayuki Okamura, Takatsugu Yamamoto, Satoshi Kimura, Atsushi Miki, Koichiro Abe, Hiroto Kita
BACKGROUND: Lubiprostone is effective for patients with chronic constipation. This agent sometimes causes upper gastrointestinal symptoms, such as nausea, which is one of the chief reasons for discontinuation. However, the etiology of and strategy against bothersome gastrointestinal symptoms of lubiprostone remain unclear. AIMS: The goal of this study was to investigate the influence of lubiprostone on the gastric-emptying profile of healthy adults. The effect of domperidone on gastric emptying and gastrointestinal symptoms after lubiprostone administration were also assessed...
September 21, 2017: International Journal of Clinical Pharmacology and Therapeutics
https://www.readbyqxmd.com/read/28919541/drugs-for-treating-opioid-induced-constipation-a-mixed-treatment-comparison-network-meta-analysis-of-randomized-controlled-clinical-trials
#7
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/28840678/-pathomechanism-and-treatment-of-gut-microbiota-dysbiosis-in-chronic-kidney-disease-and-interventional-effects-of-chinese-herbal-medicine
#8
REVIEW
Wen-Bei Han, Ying-Lu Liu, Yi-Gang Wan, Wei Sun, Yue Tu, Jing-Jing Yang, Wei Wu, Wei-Ming He, Jian Yao
The gut microbiota dysbiosis is one of the risk factors in the progression from the advanced chronic kidney disease(CKD)to uremia, characterized by the reduction of probiotics and the increase of opportunistic pathogens including urease-related microbes, endotoxin-related microbes and toxin-related microbes, which can produce uremic toxins. According to the core point of "the gut-kidney axis" theory and "the chronic kidney disease-colonic axis" concept, the gut microbiota dysbiosis aggravates renal damage by accumulating uremic toxins and inducing the systemic micro-inflammation...
July 2017: Zhongguo Zhong Yao za Zhi, Zhongguo Zhongyao Zazhi, China Journal of Chinese Materia Medica
https://www.readbyqxmd.com/read/28830131/-pharmacotherapy-in-patients-with-chronic-constipation
#9
REVIEW
Sang Jin Kim, Kyung Sik Park
Chronic constipation is one of the most common digestive diseases frequently observed in a clinical setting. It has been known to cause considerable damage to the quality of life of patients. Despite recent developments, there are considerable limitations in the use of constipation-modulating agents in Korea. Chloride channel inhibitors, such as lubiprostone and linaclotide, have not been introduced in Korea yet, and prucalopride and several kinds of polyethylene glycol are not covered under medical insurance...
August 25, 2017: Korean Journal of Gastroenterology, Taehan Sohwagi Hakhoe Chi
https://www.readbyqxmd.com/read/28729815/symposium-report-an-evidence-based-approach-to-ibs-and-cic-applying-new-advances-to-daily-practice-a-review-of-an-adjunct-clinical-symposium-of-the-american-college-of-gastroenterology-meeting-october-16-2016-%C3%A2-las-vegas-nevada
#10
William D Chey
Many nonpharmacologic and pharmacologic therapies are available to manage irritable bowel syndrome (IBS) and chronic idiopathic constipation (CIC). The American College of Gastroenterology (ACG) regularly publishes reviews on IBS and CIC therapies. The most recent of these reviews was published by the ACG Task Force on the Management of Functional Bowel Disorders in 2014. The key objective of this review was to evaluate the efficacy of therapies for IBS or CIC compared with placebo or no treatment in randomized controlled trials...
February 2017: Gastroenterology & Hepatology
https://www.readbyqxmd.com/read/28573175/lubiprostone-improves-visualization-of-small-bowel-for-capsule-endoscopy-a-double-blind-placebo-controlled-2-way-crossover-study
#11
Mizue Matsuura, Masahiko Inamori, Yumi Inou, Kenji Kanoshima, Takuma Higurashi, Hidenori Ohkubo, Hiroshi Iida, Hiroki Endo, Takashi Nonaka, Akihiko Kusakabe, Shin Maeda, Atsushi Nakajima
BACKGROUND AND STUDY AIMS:  Lubiprostone has been reported to be an anti-constipation drug. The aim of the study was to investigate the usefulness of lubiprostone both for bowel preparation and as a propulsive agent in small bowel endoscopy. PATIENTS AND METHODS:  This was a double-blind, placebo-controlled, 2-way crossover study of subjects who volunteered to undergo capsule endoscopy (CE). A total of 20 subjects (16 male and 4 female volunteers) were randomly assigned to receive a 24-μg tablet of lubiprostone 120 minutes prior to capsule ingestion for CE (L regimen), or a placebo tablet 120 minutes prior to capsule ingestion for CE (P regimen)...
June 2017: Endoscopy International Open
https://www.readbyqxmd.com/read/28483009/clinical-and-functional-characteristics-of-nursing-facility-residents-with-opioid-induced-constipation
#12
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/28424169/identification-of-the-fatty-acid-activation-site-on-human-clc-2
#13
John Cuppoletti, Kirti P Tewari, Jayati Chakrabarti, Danuta H Malinowska
Fatty acids (including lubiprostone and cobiprostone) are human ClC-2 (hClC-2) Cl(-) channel activators. Molecular and cellular mechanisms underlying this activation were examined. Role of a four-amino acid PKA activation site, RGET691, of hClC-2 was investigated using wild-type (WT) and mutant (AGET, RGEA, and AGAA) hClC-2 expressed in 293EBNA cells as well as involvement of PKA, intracellular cAMP concentration ([cAMP]i), EP2, or EP4 receptor agonist activity. All fatty acids [lubiprostone, cobiprostone, eicosatetraynoic acid (ETYA), oleic acid, and elaidic acid] caused significant rightward shifts in concentration-dependent Cl(-) current activation (increasing EC50s) with mutant compared with WT hClC-2 channels, without changing time and voltage dependence, current-voltage rectification, or methadone inhibition of the channel...
June 1, 2017: American Journal of Physiology. Cell Physiology
https://www.readbyqxmd.com/read/28423917/management-of-opioid-induced-constipation-in-hospice-patients
#14
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/28410751/mizagliflozin-a-novel-selective-sglt1-inhibitor-exhibits-potential-in-the-amelioration-of-chronic-constipation
#15
Toshihiro Inoue, Masaaki Takemura, Nobuhiko Fushimi, Yoshikazu Fujimori, Tomoya Onozato, Takao Kurooka, Tetsuya Asari, Hiroo Takeda, Mamoru Kobayashi, Hironori Nishibe, Masayuki Isaji
Chronic constipation is a highly common functional gastrointestinal disorder that adversely affects patient quality of life. At present, limited therapeutic options are available for the treatment of chronic constipation, which indicates the need for new therapeutic agents. Herein, we report the potential of mizagliflozin, a novel selective sodium glucose co-transporter 1 (SGLT1) inhibitor, for the amelioration of chronic constipation. Mizagliflozin's inhibitory activity against SGLTs was evaluated by an in vitro assay of cells transiently expressing SGLTs...
July 5, 2017: European Journal of Pharmacology
https://www.readbyqxmd.com/read/28410406/lubiprostone-improves-intestinal-permeability-in-humans-a-novel-therapy-for-the-leaky-gut-a-prospective-randomized-pilot-study-in-healthy-volunteers
#16
RANDOMIZED CONTROLLED TRIAL
Takayuki Kato, Yasushi Honda, Yusuke Kurita, Akito Iwasaki, Takamitsu Sato, Takaomi Kessoku, Shiori Uchiyama, Yuji Ogawa, Hidenori Ohkubo, Takuma Higurashi, Takeharu Yamanaka, Haruki Usuda, Koichiro Wada, Atsushi Nakajima
BACKGROUND AND AIMS: The barrier function of the small intestinal mucosa prevents the introduction of undesired pathogens into the body. Breakdown of this barrier function increases intestinal permeability. This has been proposed to induce not only gastrointestinal diseases, including inflammatory bowel disease and irritable bowel syndrome, but also various other diseases, including allergies, diabetes mellitus, liver diseases, and collagen diseases, which are associated with this so called "leaky gut syndrome...
2017: PloS One
https://www.readbyqxmd.com/read/28238460/-irritable-bowel-syndrome-with-constipation-and-functional-constipation-in-adults-treatment-part-2-of-2
#17
F Mearin, C Ciriza, M Mínguez, E Rey, J J Mascort, E Peña, P Cañones, J Júdez
In this Clinical practice guide we examine the diagnostic and therapeutic management of adult patients with constipation and abdominal discomfort, at the confluence of the spectrum of irritable bowel syndrome and functional constipation. Both fall within the framework of functional intestinal disorders and have major personal, health and social impact, altering the quality of life of the patients affected. The former is a subtype of irritable bowel syndrome in which constipation and altered bowel habit predominate, often along with recurring abdominal pain, bloating and abdominal distension...
March 2017: Atencion Primaria
https://www.readbyqxmd.com/read/28236087/gastrointestinal-pharmacology
#18
REVIEW
Miguel Saps, Adrian Miranda
There is little evidence for most of the medications currently used to treat functional abdominal pain disorders (FAPDs) in children. Not only are there very few clinical trials, but also most have significant variability in the methods used and outcomes measured. Thus, the decision on the most appropriate pharmacological treatment is frequently based on adult studies or empirical data. In children, peppermint oil, trimebutine, and drotaverine have shown significant benefit compared with placebo, each of them in a single randomized clinical trial...
2017: Handbook of Experimental Pharmacology
https://www.readbyqxmd.com/read/28116695/update-on-the-management-of-chronic-constipation
#19
REVIEW
Jenna Koliani-Pace, Brian E Lacy
Chronic constipation (CC) is a highly prevalent disorder encountered by health care providers of all specialties. The diagnosis can be confidently made by taking a careful history, evaluating for warning signs and symptoms, performing an examination, including a digital rectal exam, and using the Rome IV criteria. Treatment should begin at the first visit; most patients require few diagnostic tests to make, or confirm, the diagnosis of CC. Assuming that the patient has persistent symptoms of constipation, despite using traditional therapy (fiber, osmotic agents), then patients should be offered one of the newer treatments, rather than repeating prior treatments, which is a common practice...
March 2017: Current Treatment Options in Gastroenterology
https://www.readbyqxmd.com/read/28070176/advances-in-ibs-2016-a-review-of-current-and-emerging-data
#20
Philip S Schoenfeld
Irritable bowel syndrome (IBS) is characterized by chronic intermittent abdominal pain and associated diarrhea (IBS-D), constipation (IBS-C), or both. IBS can significantly impact patient function and quality of life. The diagnosis of IBS is based on the presence of characteristic symptoms, the exclusion of concerning features, and selected tests to exclude organic diseases that can mimic IBS. The pathophysiology of IBS remains incompletely understood, and new contributing factors have been identified over the past decade...
August 2016: Gastroenterology & Hepatology
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