Opioid Induced Constipation Part I: Established Management Strategies #294

Badke, Andrew; Rosielle, Drew A.

doi:10.1089/jpm.2015.0154

Cited by 3 publications

(2 citation statements)

References 15 publications

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“…Such recommendations may be feasible for active noncancer pain patients, but may be unsuitable for patients with advanced illness, impaired mobility, dietary restrictions, and/or limited function 26. The pharmacological component of a bowel regimen may include stool softeners, bulking agents, osmotic agents, and stimulant-type laxatives 27.…”

Section: Oic Managementmentioning

confidence: 99%

Peripherally acting μ-opioid receptor antagonists as treatment options for constipation in noncancer pain patients on chronic opioid therapy

Pergolizzi

Raffa

Pappagallo

et al. 2017

PPA

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Opioid-induced constipation (OIC), a prevalent and distressing side effect of opioid therapy, does not reliably respond to treatment with conventional laxatives. OIC can be a treatment-limiting adverse event. Recent advances in medications with peripherally acting μ-opioid receptor antagonists, such as methylnaltrexone, naloxegol, and alvimopan, hold promise for treating OIC and thus extending the benefits of opioid analgesia to more chronic pain patients. Peripherally acting μ-opioid receptor antagonists have been clinically tested to improve bowel symptoms without compromise to pain relief, although there are associated side effects, including abdominal pain. Other treatment options include fixed-dose combination products of oxycodone analgesic together with naloxone.

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Section: Oic Managementmentioning

confidence: 99%

Peripherally acting μ-opioid receptor antagonists as treatment options for constipation in noncancer pain patients on chronic opioid therapy

Pergolizzi

Raffa

Pappagallo

et al. 2017

PPA

View full text Add to dashboard Cite

show abstract

“…While laxatives are often the first treatment option for OIC, they frequently yield complications and poor outcomes. 77–79 OIC can be also improved by use of opioid antagonists such as naloxone 80 81 ; however, naloxone crosses the BBB and decreases opioid analgesia. 72 82–84 PAMORAs are able to reduce the symptoms of OIC while maintaining the efficacy of opioid agonists in the CNS.…”

Section: Introductionmentioning

confidence: 99%

Blood–brain barrier: mechanisms governing permeability and interaction with peripherally acting μ-opioid receptor antagonists

Viscusi

2020

Reg Anesth Pain Med

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The blood–brain barrier (BBB) describes the unique properties of endothelial cells (ECs) that line the central nervous system (CNS) microvasculature. The BBB supports CNS homeostasis via EC-associated transport of ions, nutrients, proteins and waste products between the brain and blood. These transport mechanisms also serve as physiological barriers to pathogens, toxins and xenobiotics to prevent them from contacting neural tissue. The mechanisms that govern BBB permeability pose a challenge to drug design for CNS disorders, including pain, but can be exploited to limit the effects of a drug to the periphery, as in the design of the peripherally acting μ-opioid receptor antagonists (PAMORAs) used to treat opioid-induced constipation. Here, we describe BBB physiology, drug properties that affect BBB penetrance and how data from randomized clinical trials of PAMORAs improve our understanding of BBB permeability.

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Palliative care and hospice care in neuro-oncology

Sahebjam,

Pedowitz,

Mahon

et al. 2024

Neuropsychological and Psychosocial Foundations of Neuro-Oncology

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Opioid Induced Constipation Part I: Established Management Strategies #294

Cited by 3 publications

References 15 publications

Peripherally acting μ-opioid receptor antagonists as treatment options for constipation in noncancer pain patients on chronic opioid therapy

Peripherally acting μ-opioid receptor antagonists as treatment options for constipation in noncancer pain patients on chronic opioid therapy

Blood–brain barrier: mechanisms governing permeability and interaction with peripherally acting μ-opioid receptor antagonists

Palliative care and hospice care in neuro-oncology

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Opioid Induced Constipation Part I: Established Management Strategies #294

Cited by 3 publications

References 15 publications

Peripherally acting &mu;-opioid receptor antagonists as treatment options for constipation in noncancer pain patients on chronic opioid therapy

Peripherally acting &mu;-opioid receptor antagonists as treatment options for constipation in noncancer pain patients on chronic opioid therapy

Blood–brain barrier: mechanisms governing permeability and interaction with peripherally acting μ-opioid receptor antagonists

Palliative care and hospice care in neuro-oncology

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Product

Resources

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Peripherally acting μ-opioid receptor antagonists as treatment options for constipation in noncancer pain patients on chronic opioid therapy

Peripherally acting μ-opioid receptor antagonists as treatment options for constipation in noncancer pain patients on chronic opioid therapy