Management of opioid-induced gastrointestinal effects in patients receiving palliative care.
Opioid-induced gastrointestinal side effects, namely, nausea and constipation, are bothersome yet often easy to manage. Due to their widespread frequency, it is imperative that prophylactic and treatment modalities be understood. Although many pharmacotherapeutic agents are available with which to prevent or treat these side effects, few randomized, placebo-controlled studies have been conducted in terminally ill patients, thus limiting most treatment decisions to empiric therapies based on extrapolated data. A strong understanding of the pathophysiology of the sequelae is therefore paramount. Common agents administered for nausea are butyrophenones, phenothiazines, metoclopramide, and serotonin-receptor antagonists. Those given to manage constipation are stimulant laxatives and stool softeners, individually or in combination.
Herndon
Christopher M
CM
School of Pharmacy, Texas Tech University Health Sciences Center, Lubbock, USA. cherndon@ompus.jnj.com
Jackson
Kenneth C
KC
Hallin
Pamala A
PA
D000701:Analgesics, Opioid / Q000009:adverse effects* / Q000627:therapeutic use; D000932:Antiemetics / Q000627:therapeutic use; D014150:Antipsychotic Agents / Q000627:therapeutic use; D002090:Butyrophenones; D002400:Cathartics / Q000627:therapeutic use; D003248:Constipation / Q000139:chemically induced / Q000188:drug therapy* / Q000503:physiopathology; D004064:Digestive System / Q000187:drug effects / Q000473:pathology; D018492:Dopamine Antagonists / Q000627:therapeutic use; D018757:GABA Modulators / Q000627:therapeutic use; D005765:Gastrointestinal Agents / Q000627:therapeutic use*; D006634:Histamine H1 Antagonists / Q000627:therapeutic use; D006801:Humans; D018727:Muscarinic Antagonists / Q000627:therapeutic use; D009325:Nausea / Q000139:chemically induced / Q000188:drug therapy* / Q000503:physiopathology; D010146:Pain / Q000188:drug therapy; D010166:Palliative Care; D010640:Phenothiazines; D012702:Serotonin Antagonists / Q000627:therapeutic use
D000701:Analgesics, Opioid; D000932:Antiemetics; D014150:Antipsychotic Agents; D002090:Butyrophenones; D002400:Cathartics; D018492:Dopamine Antagonists; D018757:GABA Modulators; D005765:Gastrointestinal Agents; D006634:Histamine H1 Antagonists; D018727:Muscarinic Antagonists; D010640:Phenothiazines; D012702:Serotonin Antagonists