Tu1467 A Randomized, Placebo-Controlled Trial Comparing the Effects of Tapentadol and Oxycodone on Gastrointestinal and Colonic Transit in Healthy Humans

Jeong, In Du; Camilleri, Michael; Shin, Andrea; Iturrino, Johanna; Boldingh, Amy; Busciglio, Irene; Burton, Duane D.; Ryks, Michael; Rhoten, Deborah; Zinsmeister, Alan R.

doi:10.1016/s0016-5085(12)63261-2

Cited by 2 publications

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“…Administration of µ-opiate receptor agonists results in delayed gastric emptying and also may cause nausea and vomiting. These include agents such as morphine (25), as well as oxycodone and tapentadol (26), but less with tramadol (27). Therefore, patients receiving such agents should first undergo withdrawal of the agent before assuming a diagnosis of gastroparesis.…”

Section: Identifying the Cause Of Gastroparesismentioning

confidence: 99%

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Clinical Guideline: Management of Gastroparesis

Camilleri¹,

Parkman²,

Shafi³

et al. 2013

American Journal of Gastroenterology

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976

996

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This guideline presents recommendations for the evaluation and management of patients with gastroparesis. Gastroparesis is identified in clinical practice through the recognition of the clinical symptoms and documentation of delayed gastric emptying. Symptoms from gastroparesis include nausea, vomiting, early satiety, postprandial fullness, bloating, and upper abdominal pain. Management of gastroparesis should include assessment and correction of nutritional state, relief of symptoms, improvement of gastric emptying and, in diabetics, glycemic control. Patient nutritional state should be managed by oral dietary modifications. If oral intake is not adequate, then enteral nutrition via jejunostomy tube needs to be considered. Parenteral nutrition is rarely required when hydration and nutritional state cannot be maintained. Medical treatment entails use of prokinetic and antiemetic therapies. Current approved treatment options, including metoclopramide and gastric electrical stimulation (GES, approved on a humanitarian device exemption), do not adequately address clinical need. Antiemetics have not been specifically tested in gastroparesis, but they may relieve nausea and vomiting. Other medications aimed at symptom relief include unapproved medications or off-label indications, and include domperidone, erythromycin (primarily over a short term), and centrally acting antidepressants used as symptom modulators. GES may relieve symptoms, including weekly vomiting frequency, and the need for nutritional supplementation, based on open-label studies. Second-line approaches include venting gastrostomy or feeding jejunostomy; intrapyloric botulinum toxin injection was not effective in randomized controlled trials. Most of these treatments are based on open-label treatment trials and small numbers. Partial gastrectomy and pyloroplasty should be used rarely, only in carefully selected patients. Attention should be given to the development of new effective therapies for symptomatic control.

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Section: Identifying the Cause Of Gastroparesismentioning

confidence: 99%

“…No data are available in patients with gastroparesis. Both the related compound, tapentadol, and the more selective µ -opioid receptor agonist, oxycodone, are reported to retard gastric emptying in healthy subjects (26). …”

Section: Pharmacologic Therapymentioning

confidence: 99%

Clinical Guideline: Management of Gastroparesis

Camilleri¹,

Parkman²,

Shafi³

et al. 2013

American Journal of Gastroenterology

Self Cite

976

996

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“…145,154,155 Los agonistas opioides estimulan el tono del esfínter pilórico e inhiben la contractilidad antral con el consecuente retraso del VG. 156 Incluyen la codeína, la morfina y la oxicodona, 157,158 observándose un menor efecto con el tramadol. 159 Los agentes hipoglucemiantes como los análogos de la amilina (pramlintida) y los análogos o agonistas del péptido 1 similar a glucagón (GLP1) (liraglutida y exenatida) pueden retrasar el VG.…”

Section: Gastroparesia Secundaria a Fármacosunclassified

Dispepsia funcional y gastroparesia: ¿dos entidades superpuestas? De la fisiopatología a la terapéutica

Manresa¹,

Carboné²,

Díez³

2021

Acta gastroenterol. latinoam.

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Functional dyspepsia and gastroparesis represent the most common sensory-motor disorders of the upper gastrointestinal tract. Scientific advances in the last decade have shown that there is significant overlap between them. This review aims to address current knowledge about their pathophysiology, diagnosis and treatment. Functional dyspepsia is a medical condition that is characterized by one or more of the following symptoms: early satiety, postprandial fullness, and epigastric pain or burning. The pathophysiological mechanisms involved are: the gastroduodenal motility and sensory abnormalities, the immune dysfunction, the duodenal inflammation, the gastrointestinal infections, the alterations in the gastrointestinal microbiota and the dysfunction of the gut-brain axis. The Rome IV criteria make possible to establish a presumptive diagnosis of functional dyspepsia in most patients, although it continues to be a diagnosis of exclusion that requires the performance of an upper digestive video endoscopy to confirm it. The recommended therapeutic options are: the eradication of Helicobacter pylori, the proton pump inhibitors, the tricyclic antidepressants and prokinetics. Gastroparesis is a chronic disorder characterized by delayed gastric emptying in the absence of a mechanical obstruction. The pathophysiology is caused by neuromuscular abnormalities of gastric motor function. Gastric emptying scan is the current gold standard for diagnosis. The mainstays of treatment are restoration of hydration and nutrition, and pharmacological treatment with prokinetics and antiemetics.

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Tu1467 A Randomized, Placebo-Controlled Trial Comparing the Effects of Tapentadol and Oxycodone on Gastrointestinal and Colonic Transit in Healthy Humans

Cited by 2 publications

References 0 publications

Clinical Guideline: Management of Gastroparesis

Clinical Guideline: Management of Gastroparesis

Dispepsia funcional y gastroparesia: ¿dos entidades superpuestas? De la fisiopatología a la terapéutica

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