Opioid-Induced Constipation in Advanced Illness: Safety and Efficacy of Methylnaltrexone Bromide

Bader, Sabine; Jaroslawski, Karin; Blum, Hubert E.; Becker, Gerhild

doi:10.4137/cmo.s4867

Cited by 31 publications

(30 citation statements)

References 27 publications

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“…All these benefits in OIC were observed without any detrimental impact on analgesia or opioid requirement. However, the risk of myocardial infarction seems to be increased with the longterm use of alvimopan [30]. It should be reminded here that alvimopan has yet not been approved for OIC.…”

Section: Pamorasmentioning

confidence: 91%

“…Another benefit noticed was the rapid onset of action with among the patients who had laxation within the first 4 h, half having it within 30 min of the drug administration [13]. In patients with creatinine clearance of <30 ml/min, 50% dose reduction has been recommended [30]. Some cases of bowel perforation have been observed, especially in patients with an underlying bowel disease [35].…”

Section: Pamorasmentioning

confidence: 97%

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Opioid-induced constipation

Gyawali

Hayashi

Tsukuura

et al. 2015

Scandinavian Journal of Gastroenterology

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Opioid-induced constipation (OIC) is a very troublesome, difficult to manage and a nearly universal complication of chronic opioid use to control pain associated with advanced illness. Some studies have reported that OIC is so intolerable in some patients that they skip their opioid medications and bear pain instead of OIC. Laxatives have commonly been used as a prophylaxis and treatment of OIC but they are frequently ineffective because the commonly available laxatives do not target the underlying mechanism of OIC, which is the blockade of peripheral mu-receptors. Recently, there have been a number of advances in the treatment of OIC, which any physician involved with opioid-prescribing discipline should be aware of. This review will update the new options and strategies available for treating OIC along with the relevant clinical trials. Finally, this review also provides a recommendation on the preferred way to approach a patient with OIC in the modern era as well as highlight on the importance of doctor-patient communication in this setting.

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Section: Pamorasmentioning

confidence: 91%

Section: Pamorasmentioning

confidence: 97%

Opioid-induced constipation

Gyawali

Hayashi

Tsukuura

et al. 2015

Scandinavian Journal of Gastroenterology

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“…It is a common problem (Rhondali, Nguyen et al 2013, Van Lancker, Velghe et al 2014) and has been found to be one of the "top 10" of bothersome symptoms for patient's receiving palliative care (Esper 2010, Potter, Hami et al 2003, Walsh, Donnelly et al 2000. Many symptoms may occur as a consequence from constipation, as abdominal pain, increased weakness (Downing, Kuziemsky et al 2007), decreased appetite, nausea (Clark, Smith et al 2012), haemorrhoids, faecal incontinence (Eoff, Lembo 2008), bloating and vomiting (Bader, Jaroslawski et al 2011). …”

Section: Constipationmentioning

confidence: 99%

Constipation in palliative care : Prevalence, definitions, symptom distress and risk-factors

Erichsén¹

2015

Linköping Studies in Health Sciences. Thesis

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Background and aims: Constipation for patients in palliative care is common and described with variations in prevalence. Side -effects from opioid- treatment, is considered to be one of the main factors leading to constipation. The overall aim of the thesis was to study constipation among patients admitted to specialized palliative care- settings in Sweden. The specific aims of the thesis were 1) To describe and explore the prevalence, definition and symptom distress of constipation by applying different definitions of constipation, in patients admitted to specialized palliative care settings in Sweden. 2) To identify factors related to constipation in patients in specialized palliative care and comparing these factors for patients with different types of constipation to patients without constipation. Methods: A literature- search were conducted where prevalence of- and factors related to constipation was explored and included in a questionnaire, developed for this thesis. Data was collected in a cross- sectional design with a response rate of 50% and analysed with logistic regression. Results: A total of 485 patients from 38 specialized palliative care- units in Sweden participated. Prevalence of constipation for patients in specialized palliative care varied between 7- 43 % depending on definition used. Two different constipation- groups were identified: Medical constipation- group 23% (MCG) and Perceived constipation- group 35% (PCG). Three sub- groups was also identified: patients with i) only ≤ 3 defecations/week, 7%, ii) only perception of being constipated, 19%, and iii) patients with both ≤ 3 defecations/ week and perception of being constipated,16%. Several factors were found to be related to constipation as hospitalisation, absence of laxative- treatment, haemorrhoids, poor appetite, hard stool form and opioids. Conclusions: Prevalence of constipation may differ depending on definitions used. Distress from constipation and other factors related to constipation, than opioids, needs to be incorporated into the clinical constipation- assessment. Validated constipation assessment tool needs to be developed.

The series name Linköping University, Studies in Health Sciences, Thesis in the Licentiate thesis is incorrect. The correct name is Linköping Studies in Health Sciences. Thesis.

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“…Opioid receptor antagonists (e.g. Methylnaltrexone) inhibit opioid actions in the opioid receptors on the gastrointestinal tract and it used when reduced response to laxative [34].…”

Section: Pharmacological Managementmentioning

confidence: 99%

Bowel Management: Constipation among Patients with Cancer

Younes¹,

Tawalbeh²

2017

J Palliat Care Med

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Constipation has a negative effect on patients with cancer and their families. It negatively affects the quality of life terms of physical, social, psychological, and spiritual dimensions. The aim of this paper was to review the studies that addressed constipation among patients with cancer and to explore its influence on the quality of life and wellbeing for patients and their families. Completed studies were identified through systematic search using Cumulative index for Nursing and Applied Health Literature, EBSCO Host, Ovid Journal and PubMed. This search located the studies that were published between 1989 and 2015 about constipation effect, pathophysiology, assessment and management. The review identified 44 studies and indicated that constipation has negative effect on QOL among patient with cancer and their families. Various assessment and management constipation tools and strategies were used according to patient's health condition. Pharmacological and non-pharmacological methodologies were used to manage constipation. Appropriate assessment has a positive impact on effective management of constipation among patients with cancer; that may help improve the quality of life. Nurses play a significant role in performing comprehensive assessment strategies to detect the risk factor for constipation and applying the prevention precaution to reduce opportunity of its occurrence. Nurses should perform constipation management strategies that include both pharmacological and non-pharmacological approaches.

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Opioid-Induced Constipation in Advanced Illness: Safety and Efficacy of Methylnaltrexone Bromide

Cited by 31 publications

References 27 publications

Opioid-induced constipation

Opioid-induced constipation

Constipation in palliative care : Prevalence, definitions, symptom distress and risk-factors

Bowel Management: Constipation among Patients with Cancer

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