Abstract | CONTEXT:
Opioid-induced bowel dysfunction (OBD) is characterized by constipation, incomplete evacuation, bloating, and increased gastric reflux. OBD occurs both acutely and chronically, in multiple disease states, resulting in increased morbidity and reduced quality of life. OBJECTIVE: To compare the efficacy and safety of traditional and peripherally active opioid antagonists vs conventional interventions for OBD. DESIGN: We searched MEDLINE, the Cochrane Central Register of Controlled Trials and EMBASE. Additional reports were identified from the reference lists of retrieved articles. STUDY SELECTION: Studies were included if they were randomized controlled trials that investigated the efficacy of mu- opioid antagonists for OBD. DATA EXTRACTION: Data were extracted by two independent investigators and included demographic variables, diagnoses, interventions, efficacy, and adverse events. RESULTS OF DATA SYNTHESIS: CONCLUSIONS: Insufficient evidence exists for the safety or efficacy of naloxone or nalbuphine in the treatment of OBD. Long-term efficacy and safety of any of the opioid antagonists is unknown, as is the incidence or nature of rare adverse events. Alvimopan and methylnaltrexone both show promise in treating OBD, but further data will be required to fully assess their place in therapy.
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Authors | Ewan McNicol, David B Boyce, Roman Schumann, Daniel Carr |
Journal | Pain medicine (Malden, Mass.)
(Pain Med)
Vol. 9
Issue 6
Pg. 634-59
(Sep 2008)
ISSN: 1526-4637 [Electronic] England |
PMID | 18828197
(Publication Type: Journal Article, Meta-Analysis, Research Support, Non-U.S. Gov't, Review, Systematic Review)
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Chemical References |
- Analgesics, Opioid
- Narcotic Antagonists
- Receptors, Opioid, mu
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Topics |
- Analgesics, Opioid
(adverse effects, therapeutic use)
- Animals
- Gastrointestinal Diseases
(chemically induced, drug therapy)
- Humans
- Narcotic Antagonists
(adverse effects, therapeutic use)
- Randomized Controlled Trials as Topic
(adverse effects)
- Receptors, Opioid, mu
(antagonists & inhibitors, physiology)
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