Current concepts in the management of opioid-induced constipation: A perfect review with an imperfect concept

Xiulu Ruan, MD; Marcos Montagnini, MD, FACP; Brandon JB Walters, MD

doi:10.5055/jom.2011.0059

Authors

Xiulu Ruan, MD
Marcos Montagnini, MD, FACP
Brandon JB Walters, MD

DOI:

https://doi.org/10.5055/jom.2011.0059

Keywords:

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Abstract

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Author Biographies

Xiulu Ruan, MD

Director of Clinical Research Physicians’ Pain Specialists of Alabama, PC Mobile, Alabama

Marcos Montagnini, MD, FACP

Director, Palliative Care VA Ann Arbor Healthcare System Associate Professor of Medicine Division of Geriatric Medicine University of Michigan Ann Arbor, Michigan

Brandon JB Walters, MD

Hospice of the Western Reserve Cleveland, Ohio

References

Rotsheeyn Y, Boyd TA, Yuan CS: Methylnaltrexone bromide: Research update of pharmacokinetics following parenteral administration. Expert Opin Drug Metab Toxicol. 2011 Feb;7(2): 227-235.

Iyer SS, Randazzo BP, Tzanis EL, et al.: Effect of subcutaneous methylnaltrexone on patient-reported constipation symptoms. Value Health. 2011 Jan; 14(1): 177-183.

Licup N, Baumrucker SJ: Methylnaltrexone: Treatment for opioid-induced constipation. Am J Hosp Palliat Care. 2011 Feb; 28(1): 59-61.

Leppert W: The role of opioid receptor antagonists in the treatment of opioid-induced constipation: A review. Adv Ther. 2010 Oct; 27(10): 714-730.

McNicol E, Boyce DB, Schumann R, et al.: Efficacy and safety of m-opioid antagonists in the treatment of opioid-induced bowel dysfunction: Systemic review and meta-analysis of randomized controlled trials. Pain Med. 2008 Sept; 9(6): 634-659.

Anderson VC, Burchiel KJ: A prospective study of long-term intrathecal morphine in the management of chronic nonmalignant pain. Congress of Neurological Surgeons. Vol 44(2), Feb. 1999, pp 289-300.

Ruan X: Drug-related side effects of long-term intrathecal morphine therapy. Pain Physician. 2007 Mar; 10(2): 357-366.

Di Chiro G. Observations on the circulation of the CSF. Acta Radiol. 1996; 5: 988-1002.

Hansdottir V, Hedner T, Woestenborghs R, et al.: The CSF and plasma pharmacokinetics of sufentanil after intrathecal administration. Anesthesiology. 1991; 74: 264-269.

Porreca F, Filla A, Burks TF: Spinal cord mediated opiate effects on gastrointestinal transit in mice. Eur J Pharmacol. 1983; 86: 135-136.

Thoren T, Wattwil M: Effects on gastric emptying of thoracic epidural analgesia with morphine or bupivacaine. Anesth Analg. 1988; 67: 687-694.

He L, Kim J, Ou C, et al.: Methadone antinociception is dependent on peripheral opioid receptors. J Pain. 2009; 10(4): 369-379.

Walters JB, Montagnini M: Current concepts in the management of opioid-induced constipation. J Opioid Manage. 2010; 6(6): 435-444.

Stein C, Lang LJ: Peripheral mechanisms of analgesia. Curr Opin Pharmacol. 2009; 9(1): 3-8.

Stein C, Clark JD,Oh U, et al.: Peripheral mechanisms of pain and analgesia. Brain Res Rev. 2009; 60(1): 90-113.

Anderson VC, Burchiel KJ: A prospective study of ong-term intrathecal morphine in the management of chronic non-malignant pain. Congress of Neurological Surgeons. 1999; 44(2): 289-300.

Yaksh TL, Noveihed R: The physiology and pharmacology of spinal opiates. Ann Rev Pharmacol Toxicol. 1985; 25: 433-462.

Porreca F, Filla A, Burks TF: Spinal cord mediated opiate effects on gastrointestinal transit time. Eur J Pharmacol. 1983; 86: 135-136.

Ruan X: Drug-related side effects of long-term intrathecal morphine therapy. Pain Physician. 2007; 10(2): 357-366.

Liu M, Wittbrodt E: Low-dose oral naloxone reverses opioidinduced constipation and analgesia. J Pain Symptom Manage. 2002; 23: 48-53.

Thomas JF, Cooney GA: Palliative care and pain: New strategies for managing opioid induced-bowel dysfunction. J Palliat Med. 2008; 11(S): S1-S9.

Meissner W, Leyendecker P, Mueller-Lissner S, et al.: A randomized controlled trial with prolonged-release oral oxycodone and naloxone to prevent and reverse opioidinduced constipation. Eur J Pain. 2009; 13(1): 56-64.

Vondrackova D, Leyendecker P, Meissner W, et al.: Analgesic efficacy and safety of oxycodone in combination with naloxone as prolonged release tablets in patients with moderate to severe chronic pain. J Pain. 2008; 9(12): 1144-1154.

Arpino PA, Thompson BT: Safety of enteral naloxone for the reversal of opiate-induced constipation in the intensive care unit. J Clin Pharm Ther. 2008;34(2): 1144-1154.

He L, Kim J, Ou C, et al.: Methadone antinociception is dependent on peripheral opioid receptors. J Pain. 2009; 10(4): 369-379.

Hanks G, Cherny NI, Fallon M: Opioid Analgesic Therapy. In: Doyle D, Hanks G, Cherny N, et al. (eds.): Oxford Textbook of Palliative Medicine. Oxford, England: Oxford University Press, 2005: 316-336.

Payne R, Gonzales GR: Pathophysiology of pain in cancer and other terminal diseases. In: Doyle D, Hanks G, Cherny N, et al. (eds.): Oxford Textbook of Palliative Medicine. Oxford, England: Oxford University Press, 2005: 290-291.

Lussier D, Portenoy R: Adjuvant analgesics in pain management. In: Doyle D, Hanks G, Cherny N, et al. (eds.): Oxford Textbook of Palliative Medicine. Oxford, England: Oxford University Press, 2005: 361-362.