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Drugs Affecting GI Tract Motility: Opioids as Antidiarrheal Agents01:17

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Pharmacological therapies for IBS-C are designed to alleviate abdominal discomfort and enhance bowel function. In patients with IBS-C, fiber supplements may help soften stools and decrease straining, but may also lead to increased gas production and bloating. Osmotic laxatives like milk of magnesia are frequently used to soften stools and increase stool frequency in IBS-C patients. In addition, two drugs approved for use in severe IBS-C adult cases are linaclotide (Linzess) and lubiprostone...
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Diarrhea-predominant irritable bowel syndrome (IBS-D) is a subtype of IBS characterized primarily by frequent, loose, or watery stools, abdominal pain, and abdominal discomfort. Therapeutic approaches to managing IBS-D include dietary changes, stress management techniques, and pharmaceutical interventions.
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Opioids are a class of drugs that mimic endogenous opioid peptides and act on opioid receptors, and help in pain relief. These compounds are classified as natural, synthetic, or semi-synthetic. Natural opioids, like morphine, codeine, and thebaine, are derived from the opium poppy plant (Papaver somniferum or Papaver album) and are termed opiates. Synthetic opioids are artificial, while semi-synthetic opioids combine natural and synthetic compounds. Morphine, a prototypical opioid, possesses a...
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Synthetic and semisynthetic opioids are pivotal in pain management and tackling opioid addiction. Semisynthetic opioids, including morphinans (morphine derivatives), oxycodone, oxymorphone, hydrocodone, and hydromorphone, have improved pharmacokinetic profiles compared to morphine. Additionally, heroin and 6-MAM (6-Monoacetylmorphine) show better CNS penetration than morphine due to heightened lipid solubility. Hydromorphone, a potent opioid, undergoes hepatic metabolism to form the active...
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Laxatives are primarily used to alleviate constipation, a common gastrointestinal disorder characterized by infrequent bowel movements and difficulty passing stools. They work by various mechanisms to increase the volume or frequency of bowel movements. The primary modes of action of laxatives include increasing stool bulk, softening the stool, stimulating intestinal motility, and osmotically drawing water into the intestines.
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Acupoint Application Combined with Acupoint Massage for Treating Constipation in a Patient with Chronic Obstructive Pulmonary Disease
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Opioid-induced constipation.

Bishal Gyawali1, Naomi Hayashi, Hiroaki Tsukuura

  • 1Department of Clinical Oncology and Chemotherapy, Nagoya University Hospital , Nagoya , Japan.

Scandinavian Journal of Gastroenterology
|June 11, 2015
PubMed
Summary
This summary is machine-generated.

Opioid-induced constipation (OIC) is a common, difficult complication of pain management. New treatments targeting mu-receptors offer improved management beyond traditional laxatives.

Keywords:
Doctor–patient communicationlaxativeslinaclotidelubiprostoneopioid-induced-constipationopioidsopioid–naloxone combinationperipherally acting mu-opioid receptor antagoniststapentadol

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Area of Science:

  • Palliative Care
  • Gastroenterology
  • Pharmacology

Background:

  • Opioid-induced constipation (OIC) significantly impacts patients with advanced illness, sometimes leading to undertreatment of pain.
  • Conventional laxatives often fail to address the underlying mu-receptor blockade mechanism of OIC.
  • Effective OIC management is crucial for patient quality of life and adherence to pain therapy.

Purpose of the Study:

  • To review recent advances and new treatment strategies for OIC.
  • To discuss relevant clinical trials for emerging OIC therapies.
  • To provide guidance on modern OIC patient management and doctor-patient communication.

Main Methods:

  • Literature review of recent clinical trials and treatment options for OIC.
  • Analysis of the mechanism of action for OIC and its treatment.
  • Synthesis of current evidence to formulate management recommendations.

Main Results:

  • Traditional laxatives are often ineffective for OIC due to their mechanism.
  • Novel therapeutic agents targeting peripheral mu-receptors show promise in OIC treatment.
  • Clinical trials demonstrate varying efficacy and safety profiles for new OIC interventions.

Conclusions:

  • Advances in understanding OIC pathophysiology have led to targeted therapies.
  • Physicians must be aware of new treatment options beyond basic laxatives.
  • Optimizing OIC management requires a strategic approach and clear doctor-patient communication.