阿片类药物引起的便秘:机制和管理
Erica Becker1, Mahmoud Y Madi1, Mary Magee1
1Division of Gastroenterology and Hepatology, Department of Internal Medicine, Saint Louis University School of Medicine, St. Louis, MO, United States.
Postgraduate medical journal
|December 15, 2025
概括
阿片类药物诱导的便秘 (OIC) 显著影响慢性疼痛患者. 早期的患者教育和量身定制的药使用是关键,而外围作用的片受体对手作为有效的二线治疗.
科学领域:
- 胃肠病学 胃肠病学
- 药理学 药理学是指药理学的学科.
- 疼痛管理 疼痛管理
背景情况:
- 阿片类药物引起的便秘 (OIC) 是阿片类止痛药的常见副作用.
- OIC对患者的生活质量产生负面影响,并降低了阿片类药物的疗效.
- 在临床实践中,它往往被低诊断和管理不充分.
研究的目的:
- 审查OIC的病理生理学,临床评估和基于证据的管理.
- 为管理OIC.IC的临床医生提供实际建议.
- 强调将机械学见解与OIC的临床指导相结合.
主要方法:
- 在MEDLINE和EMBASE (2000年至2025年4月) 的综合文献搜索.
- 对相关研究,元分析和共识声明的分析.
- 对OIC管理的机制性见解和实际建议的综合.
主要成果:
- OIC是由胃肠道中片受体的激活引起的,减缓了运动性.
- 最初的治疗包括患者教育和非处方药.
- 边缘作用的片受体对抗剂是有效的二线选择,但未得到充分利用.
结论:
- 积极的患者教育和量身定制的药治疗对于OIC管理至关重要.
- 使用像肠功能指数这样的工具进行定期监测至关重要.
- 需要解决接入障碍和提高临床医生的意识,以改善先进OIC疗法的使用.
相关概念视频
Drugs Affecting GI Tract Motility: Opioids as Antidiarrheal Agents
597
Diarrhea, a condition marked by frequent loose or watery bowel movements, can be triggered by multiple factors such as viral or bacterial infections, food intolerances, anxiety, medications, and digestive disorders. Symptoms may include abdominal pain, bloating, nausea, and cramping. Severe or prolonged diarrhea can lead to complications like electrolyte imbalances, malnutrition, and dehydration if left untreated.
Opioids, widely used antidiarrheal agents, mitigate diarrhea by slowing down...
Opioids, widely used antidiarrheal agents, mitigate diarrhea by slowing down...
597
Drugs for Treatment of Constipation-Predominant IBS
676
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...
676
Analgesia and Pain Management
1.4K
Pain is critical to various clinical pathologies, provoking an urgent need for effective management. Pain, whether acute or chronic, is a complex neurochemical process. Its alleviation depends on the type, with nonopioid analgesics effective for mild to moderate pain, such as musculoskeletal or inflammatory pain, while neuropathic pain responds best to anticonvulsants, tricyclic antidepressants, or serotonin/norepinephrine reuptake inhibitors. For severe acute or chronic pain, opioids may be...
1.4K
Drugs for Treatment of Diarrhea-Predominant IBS
598
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.
Two specific drugs used in the treatment are alosetron (Lotronex) and eluxadoline (Viberzi). Alosetron, a 5-HT3 antagonist, works by slowing the movement of stools in the gut, reducing bowel...
Two specific drugs used in the treatment are alosetron (Lotronex) and eluxadoline (Viberzi). Alosetron, a 5-HT3 antagonist, works by slowing the movement of stools in the gut, reducing bowel...
598
Opioid Analgesics: Synthetic and Semisynthetic Opioids
878
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...
878
Opioid Analgesics: Morphine and Other Natural Cogeners
808
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...
808


