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Methylnaltrexone: treatment for opioid-induced constipation
Nerissa Licup1, Steven J Baumrucker
1Department of Internal Medicine, East Tennessee State University, Quillen College of Medicine, Johnson City, TN, USA.
The American Journal of Hospice & Palliative Care
|August 31, 2010
Summary
Opioid-induced constipation is a common side effect of severe pain management. Methylnaltrexone bromide offers a novel treatment for patients with advanced illness experiencing refractory constipation unresponsive to laxatives.
Area of Science:
- Pharmacology
- Gastroenterology
- Oncology
Background:
- Opioids are essential for managing severe pain in advanced disease but cause significant adverse effects.
- Opioid-induced bowel dysfunction (OIBD) frequently leads to refractory constipation, impacting patient quality of life.
- Standard laxative therapies are often insufficient for managing severe OIBD.
Purpose of the Study:
- To review the etiology and pathophysiology of opioid-induced constipation (OIBD).
- To discuss current and novel treatment strategies for OIBD.
- To highlight methylnaltrexone bromide as a treatment for refractory OIBD in advanced illness.
Main Methods:
- Literature review of pharmacology and clinical studies.
- Analysis of opioid receptor antagonism and peripheral action.
- Focus on methylnaltrexone bromide's efficacy in refractory OIBD.
Main Results:
- Opioids disrupt normal bowel function through mu-receptor agonism.
- Methylnaltrexone bromide, a peripherally acting mu-antagonist, effectively alleviates OIBD.
- Clinical data supports methylnaltrexone bromide's role in advanced illness when laxatives fail.
Conclusions:
- Opioid-induced constipation is a significant challenge in advanced disease management.
- Methylnaltrexone bromide provides a targeted therapeutic option for refractory OIBD.
- This review emphasizes methylnaltrexone bromide's value in improving quality of life for patients with OIBD.
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