A Novel Treatment for Opioid-Induced Constipation After Abdominoplasty

2017 ◽  
Vol 34 (4) ◽  
pp. 200-203
Author(s):  
R. Chad Deal ◽  
Talon Maningas ◽  
Ricardo Bonnor ◽  
Trent Fogleman
Keyword(s):  
Drug Administration ◽  
Side Effect ◽  
Food And Drug Administration ◽  
Pain Medication ◽  
Current Treatment ◽  
Chronic Noncancer Pain ◽  
Novel Treatment ◽  
Novel Approach ◽  
Bowel Movements ◽  
Noncancer Pain

Opioid-induced constipation (OIC) is a commonly experienced side effect of those utilizing narcotic pain medication. The current treatment for OIC commonly consists of stool softeners and bowel stimulants which often leads to abdominal bloating and discomfort ultimately resulting in uncomfortable bowel movements and loose stools. We present a novel approach to the treatment of acute OIC after abdominoplasty in patients taking narcotic pain medication utilizing a well-known medication currently approved by the Food and Drug Administration for the treatment of OIC in adult patients with chronic noncancer pain.

Quinacrine Hydrochloride-Induced Yellow Discoloration of the Skin in Children

PEDIATRICS ◽  
1982 ◽  
Vol 69 (2) ◽  
pp. 232-233
Author(s):  
Ronald J. Sokol ◽  
Philip K. Lichtenstein ◽  
Michael K. Farrell
Keyword(s):  
Case Report ◽  
Drug Administration ◽  
Side Effect ◽  
Common Side Effect ◽  
Clinical Method ◽  
The Past ◽  
Drug Of Choice ◽  
Bowel Movements ◽  
Alternative Drug ◽  
History Of

The drug of choice for treatment of giardiasis in children has changed over the past several years. Metronidazole (Flagyl) has been found to be carcinogenic in mice and mutagenic in bacteria,1 and is, therefore, no longer approved by the Food and Drug Administration for the treatment of giardiasis. Thus, quinacrine hydrochloride (Atabrine) is the recommended alternative drug for the treatment of giardiasis in children. The purpose of this report is to remind physicians of a common side effect of quinacrine hydrochloride and to call attention to a simple clinical method for its confirmation. CASE REPORT S.W., a 3-year-old white boy, had a three-week history of three to six loose, watery bowel movements per day.

Prevalence, Characteristics, and Management of Chronic Noncancer Pain Among People Who Use Drugs: A Cross-Sectional Study

Pain Medicine ◽  
2020 ◽  
Vol 21 (11) ◽  
pp. 3205-3214
Author(s):  
Jean-Luc Kaboré ◽  
Lise Dassieu ◽  
Élise Roy ◽  
Didier Jutras-Aswad ◽  
Julie Bruneau ◽  
...  
Keyword(s):  
Illicit Drugs ◽  
Cross Sectional Study ◽  
Pain Medication ◽  
Health Condition ◽  
People Who Use Drugs ◽  
Sectional Study ◽  
Cross Sectional ◽  
Chronic Noncancer Pain ◽  
Relieve Pain ◽  
Noncancer Pain

Abstract Introduction Most studies on chronic noncancer pain (CNCP) in people who use drugs (PWUD) are restricted to people attending substance use disorder treatment programs. This study assessed the prevalence of CNCP in a community-based sample of PWUD, identified factors associated with pain, and documented strategies used for pain relief. Methods This was a cross-sectional study nested in an ongoing cohort of PWUD in Montreal, Canada. Questionnaires were administered to PWUD seen between February 2017 and January 2018. CNCP was defined as pain lasting three or more months and not associated with cancer. Results A total of 417 PWUD were included (mean age = 44.6 ± 10.6 years, 84% men). The prevalence of CNCP was 44.8%, and the median pain duration (interquartile range) was 12 (5–18) years. The presence of CNCP was associated with older age (>45 years old; odds ratio [OR] = 1.8, 95% CI = 1.2–2.7), male sex (OR = 2.3, 95% CI = 1.2–4.2), poor health condition (OR = 1.9, 95% CI = 1.3–3.0), moderate to severe psychological distress (OR = 2.9, 95% CI = 1.8–4.7), and less frequent cocaine use (OR = 0.5, 95% CI = 0.3–0.9). Among CNCP participants, 20.3% used pain medication from other people, whereas 22.5% used alcohol, cannabis, or illicit drugs to relieve pain. Among those who asked for pain medication (N = 24), 29.2% faced a refusal from the doctor. Conclusions CNCP was common among PWUD, and a good proportion of them used substances other than prescribed pain medication to relieve pain. Close collaboration of pain and addiction specialists as well as better pain assessment and access to nonpharmacological treatments could improve pain management in PWUD.

The Effectiveness of Topical Cannabidiol Oil in Symptomatic Relief of Peripheral Neuropathy of the Lower Extremities

2020 ◽  
Vol 21 (5) ◽  
pp. 390-402 ◽  
Author(s):  
Dixon H. Xu ◽  
Benjamin D. Cullen ◽  
Meng Tang ◽  
Yujiang Fang
Keyword(s):  
Neuropathic Pain ◽  
Placebo Group ◽  
Peripheral Neuropathy ◽  
Symptomatic Relief ◽  
Symptom Relief ◽  
Treatment Algorithm ◽  
Pain Scale ◽  
Current Treatment ◽  
Chronic Noncancer Pain ◽  
Noncancer Pain

Background: Peripheral neuropathy can significantly impact the quality of life for those who are affected, as therapies from the current treatment algorithm often fail to deliver adequate symptom relief. There has, however, been an increasing body of evidence for the use of cannabinoids in the treatment of chronic, noncancer pain. The efficacy of a topically delivered cannabidiol (CBD) oil in the management of neuropathic pain was examined in this four-week, randomized and placebocontrolled trial. Methods: In total, 29 patients with symptomatic peripheral neuropathy were recruited and enrolled. 15 patients were randomized to the CBD group with the treatment product containing 250 mg CBD/3 fl. oz, and 14 patients were randomized to the placebo group. After four weeks, the placebo group was allowed to crossover into the treatment group. The Neuropathic Pain Scale (NPS) was administered biweekly to assess the mean change from baseline to the end of the treatment period. Results: The study population included 62.1% males and 37.9% females with a mean age of 68 years. There was a statistically significant reduction in intense pain, sharp pain, cold and itchy sensations in the CBD group when compared to the placebo group. No adverse events were reported in this study. Conclusions: Our findings demonstrate that the transdermal application of CBD oil can achieve significant improvement in pain and other disturbing sensations in patients with peripheral neuropathy. The treatment product was well tolerated and may provide a more effective alternative compared to other current therapies in the treatment of peripheral neuropathy.

Naldemedine for the treatment of opioid-induced constipation in adults with chronic noncancer pain

2020 ◽  
Vol 10 (5) ◽  
pp. 301-306
Author(s):  
Joy J Liu ◽  
Sarah E Quinton ◽  
Darren M Brenner
Keyword(s):  
Phase Iii ◽  
Chronic Noncancer Pain ◽  
Spontaneous Bowel Movement ◽  
First Line Therapy ◽  
Fda Approval ◽  
Opioid Receptor Antagonists ◽  
Bowel Movements ◽  
Phase Iii Trials ◽  
Us Fda ◽  
Noncancer Pain

This review aims to summarize the efficacy data for naldemedine, a member of the novel peripherally acting μ-opioid receptor antagonists (PAMORAs), which gained US FDA approval for the treatment of opioid-induced constipation in adults with chronic noncancer pain-related syndromes in 2017. In Phase III trials, patients receiving naldemedine were significantly more likely to meet the primary end point ≥3 spontaneous bowel movements/week and an increase of ≥1 spontaneous bowel movement/week from baseline for at least 9/12 weeks compared to placebo (p < 0.0001). The most frequent adverse events were abdominal pain (8%) and diarrhea (7%). Based on available data, naldemedine appears to be an effective and safe first-line therapy for the treatment of opioid-induced constipation in adults with chronic noncancer pain.

The prevalence and economic impact of prescription opioid-related side effects among patients with chronic noncancer pain

2013 ◽  
Vol 9 (4) ◽  
pp. 239-254 ◽  
Author(s):  
Jasmina I. Ivanova, MA ◽  
Howard G. Birnbaum, PhD ◽  
Yana Yushkina, BA ◽  
Rachael A. Sorg, MPH ◽  
John Reed, MD ◽  
...  
Keyword(s):  
Side Effects ◽  
Side Effect ◽  
Healthcare Costs ◽  
Claims Data ◽  
Patient Survey ◽  
Prescription Opioid ◽  
Chronic Noncancer Pain ◽  
Medical Group Practice ◽  
Outcomes Measures ◽  
Noncancer Pain

Objectives: To estimate the prevalence of opioid-related side effects among patients with chronic noncancer pain (CNCP) who initiated opioids and compare healthcare costs of patients with and without side effects using patient survey, medical charts, and claims data.Patients, participants: Patients initiating opioids, who were aged ≥18 years, had ≥1 pain diagnosis, and did not have cancer, were identified through claims data and medical records from a Central Massachusetts medical group practice and mailed surveys between October 2010 and July 2012.Main outcomes measures: Prevalence of opioid-related side effects was estimated from patient surveys, charts, and claims data within 90 days after opioid initiation (study period). Study period healthcare costs were compared between patients with and without side effects (self-reported problematic side effects or side effects recorded in medical charts or claims).Results: Among patients with CNCP who initiated opioids and completed the survey (N = 167), the average age was 53 years, and 62.9 percent were women. Based on the survey, charts, and claims, 91.6 percent, 15.0 percent, and 19.2 percent of patients, respectively, had ≥1 opioid-related side effect. Overall, 59.3 percent of patients reported having ≥1 problematic side effect or side effect recorded in charts or claims. In the analysis that controlled for baseline characteristics and resource use, patients with versus without side effects had higher mean study period healthcare costs ($3,347 vs $2,521, p = 0.049).Conclusions: Prevalence of opioid-related side effects among patients with CNCP who initiated opioids was substantially higher based on patient survey than from charts or claims. Opioid-related side effects were associated with significantly higher healthcare costs.

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