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https://www.readbyqxmd.com/read/28483009/clinical-and-functional-characteristics-of-nursing-facility-residents-with-opioid-induced-constipation
#1
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
#2
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 4-amino acid PKA activation site, RGET691 of hClC-2 was investigated using WT and mutant (AGET, RGEA and AGAA) hClC-2 expressed in 293EBNA cells as well as involvement of PKA, [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 to WT hClC-2 channels, without changing time- and voltage-dependence, I-V rectification or methadone inhibition of the channel...
April 19, 2017: American Journal of Physiology. Cell Physiology
https://www.readbyqxmd.com/read/28423917/management-of-opioid-induced-constipation-in-hospice-patients
#3
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
#4
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...
April 11, 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
#5
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
#6
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...
February 23, 2017: Atencion Primaria
https://www.readbyqxmd.com/read/28236087/gastrointestinal-pharmacology
#7
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
#8
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
#9
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
https://www.readbyqxmd.com/read/27922028/a-randomized-double-blind-placebo-controlled-trial-to-examine-the-effectiveness-of-lubiprostone-on-constipation-symptoms-and-colon-transit-time-in-diabetic-patients
#10
Jennifer Christie, Sagar Shroff, Nikrad Shahnavaz, Latoya A Carter, Melanie S Harrison, Karan A Dietz-Lindo, John Hanfelt, Shanthi Srinivasan
OBJECTIVES: Constipation is the most common GI symptom in patients with diabetes mellitus (DM). Importantly, patients with constipation have lower health-related quality of life than those without constipation. Effective therapies for constipation are limited and there is a paucity of data evaluating the treatment of constipation in diabetics. METHODS: Diabetic patients with chronic idiopathic constipation (CIC) as defined by Rome III criteria were recruited from outpatient clinics at a tertiary-care center and a Veterans Administration Hospital...
February 2017: American Journal of Gastroenterology
https://www.readbyqxmd.com/read/27815136/phenylquinoxalinone-cftr-activator-as-potential-prosecretory-therapy-for-constipation
#11
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, Alan 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. 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...
April 2017: Translational Research: the Journal of Laboratory and Clinical Medicine
https://www.readbyqxmd.com/read/27737636/addition-of-lubiprostone-to-polyethylene-glycol-peg-enhances-the-quality-efficacy-of-colonoscopy-preparation-a-randomized-double-blind-placebo-controlled-trial
#12
RANDOMIZED CONTROLLED TRIAL
Rupa Banerjee, Hrushikesh Chaudhari, Nirish Shah, Arjunan Saravanan, Manu Tandan, D Nageshwar Reddy
BACKGROUND: Adequate bowel preparation is an essential prerequisite for complete mucosal visualization during colonoscopy. Polyethylene glycol (PEG) solutions are commonly used. However the large volume of the solution is often poorly tolerated. Addition of Lubiprostone (LB) could improve the adequacy of standard PEG preparation & reduce requirement. The aims to assess adequacy of PEG preparation with addition of single dose LB (24mcg) vs placebo and efficacy of reduced dose PEG + LB compared with full dose PEG + LB...
October 13, 2016: BMC Gastroenterology
https://www.readbyqxmd.com/read/27669680/effects-of-baseline-abdominal-pain-and-bloating-on-response-to-lubiprostone-in-patients-with-irritable-bowel-syndrome-with-constipation
#13
L Chang, W D Chey, D Drossman, T Losch-Beridon, M Wang, P Lichtlen, S Mareya
BACKGROUND: Lubiprostone (8 μg b.d.) received US Food and Drug Administration (FDA) approval in 2008 for the treatment of constipation-predominant irritable bowel syndrome (IBS-C) in women aged ≥18 years. In 2012, the FDA issued new guidance for IBS-C clinical trials, recommending a composite endpoint incorporating both abdominal pain and stool frequency. AIM: In a post hoc analysis, similar criteria were applied to data from two pivotal, phase 3, double-blind, randomised trials of lubiprostone in patients with IBS-C...
November 2016: Alimentary Pharmacology & Therapeutics
https://www.readbyqxmd.com/read/27650225/lubiprostone-accelerates-intestinal-transit-and-alleviates-small-intestinal-bacterial-overgrowth-in-patients-with-chronic-constipation
#14
Irene Sarosiek, Mohammad Bashashati, Alicia Alvarez, Mark Hall, Nagasri Shankar, Yvette Gomez, Richard W McCallum, Jerzy Sarosiek
BACKGROUND: Lubiprostone is an effective treatment for chronic constipation (CC). The mechanism of action of lubiprostone is through increasing fluid secretion and lubrication of the intestinal lumen. The effects of lubiprostone on gastrointestinal transit and small intestinal bacterial overgrowth (SIBO) have not been adequately explored. The current study was designed to investigate whether lubiprostone (1) alters gastrointestinal transit and (2) affects SIBO in patients with constipation...
September 2016: American Journal of the Medical Sciences
https://www.readbyqxmd.com/read/27582887/the-role-of-naloxegol-in-the-management-of-opioid-induced-bowel-dysfunction
#15
REVIEW
Wojciech Leppert, Jaroslaw Woron
Opioid-induced constipation (OIC) and other gastrointestinal (GI) symptoms of opioid-induced bowel dysfunction (OIBD) significantly deteriorate patients' quality of life and may lead to noncompliance with opioid schedule and undertreatment of pain. Although traditional oral laxatives are the first-line treatment of OIC, they do not address OIBD pathophysiology, and display numerous adverse effects. OIC treatment includes prokinetics (lubiprostone), opioid switch, and changing route of opioid administration...
September 2016: Therapeutic Advances in Gastroenterology
https://www.readbyqxmd.com/read/27486521/persistent-constipation-and-abdominal-adverse-events-with-newer-treatments-for-constipation
#16
Irene Sonu, George Triadafilopoulos, Jerry D Gardner
BACKGROUND: Clinical trials of several new treatments for opioid-induced constipation (OIC), chronic idiopathic constipation (CIC) and constipation-predominant irritable bowel syndrome (IBS-C) have focused on differences between subjects relieved of constipation with placebo and active treatment. Patients and clinicians however, are more interested in the probability these treatments provide actual relief of constipation and its associated symptoms. METHODS: We searched the medical literature using MEDLINE and Cochrane central register of controlled trials...
2016: BMJ Open Gastroenterology
https://www.readbyqxmd.com/read/27417446/constipation-in-elderly-patients-with-noncancer-pain-focus-on-opioid-induced-constipation
#17
Sita Chokhavatia, Elizabeth S John, Mary Barna Bridgeman, Deepali Dixit
Constipation is a common and often debilitating condition in the elderly, which may be caused by underlying disease conditions, structural abnormalities in the bowel, and a variety of medications such as anticholinergics, antidepressants, and opiates. In this review, we focus on opioid-induced constipation (OIC), which is often underrecognized and undertreated in the elderly. When opioid therapy is initiated, healthcare providers are encouraged to evaluate risk factors for the development of constipation as part of a thorough patient history...
August 2016: Drugs & Aging
https://www.readbyqxmd.com/read/27331917/modern-management-of-irritable-bowel-syndrome-more-than-motility
#18
REVIEW
Jan Tack, Tim Vanuytsel, Maura Corsetti
In the treatment of irritable bowel syndrome (IBS), loperamide seems efficacious for diarrhea and ispaghula for constipation, while musculotropic spasmolytics may relieve abdominal pain. Antidepressants were found to be efficacious for abdominal pain, but their tolerance may be problematic and the therapeutic effect varied largely between trials. While meta-analyses suggest efficacy of probiotics as a group, the quality of the trials is often suboptimal and there is large variability. Lubiprostone, a chloride channel activator, and linaclotide, a guanylyl cyclase-C agonist, showed favorable effects on multiple symptoms in IBS with constipation...
2016: Digestive Diseases
https://www.readbyqxmd.com/read/27230827/clinical-practice-guideline-irritable-bowel-syndrome-with-constipation-and-functional-constipation-in-the-adult
#19
REVIEW
Fermín Mearin, Constanza Ciriza, Miguel Mínguez, Enrique Rey, Juan José Mascort, Enrique Peña, Pedro Cañones, Javier Júdez
In this Clinical Practice Guideline we discuss the diagnostic and therapeutic approach of adult patients with constipation and abdominal complaints at the confluence of the irritable bowel syndrome spectrum and functional constipation. Both conditions are included among the functional bowel disorders, and have a significant personal, healthcare, and social impact, affecting the quality of life of the patients who suffer from them. The first one is the irritable bowel syndrome subtype, where constipation represents the predominant complaint, in association with recurrent abdominal pain, bloating, and abdominal distension...
June 2016: Revista Española de Enfermedades Digestivas
https://www.readbyqxmd.com/read/27158549/review-of-efficacy-and-safety-of-laxatives-use-in-geriatrics
#20
Manhal Izzy, Anju Malieckal, Erin Little, Sury Anand
AIM: To study the efficacy and safety of pharmacological treatment of constipation in geriatrics. METHODS: PubMed, MEDLINE, google scholar, and Ovid were searched to identify human studies performed on the use of laxatives in elderly with constipation, which were conducted between January 1990 and January 2013 using the specified keywords. Controlled studies that enrolled geriatric patients with a diagnosis of constipation and addressed the efficacy and/or the safety of pharmacological treatments were included...
May 6, 2016: World Journal of Gastrointestinal Pharmacology and Therapeutics
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