A multi-institutional study analyzing effect of prophylactic medication for prevention of opioid-induced gastrointestinal dysfunction
The Clinical Journal of Pain,

Ishihara M et al. – Authors showed evidence for the effectiveness of premedication with laxatives for prevention of opioid–induced constipation. However, premedication with dopamine D2 blockers was not sufficient to prevent nausea or vomiting.

Methods
  • A multi–institutional retrospective study was carried out, in which 619 eligible hospitalized patients receiving oral opioid analgesics for cancer pain were enrolled from 35 medical institutions.
  • The primary endpoint was the incidence of opioid–induced side effects in patients receiving prophylactic medication.
  • Odds ratios of the incidence of adverse reactions in the absence or presence of premedication obtained from several institutions were subjected to a meta–analysis.

Results
  • Among 619 patients, the incidence of constipation was significantly lower in patients receiving laxatives, including magnesium oxide, as premedication than in those without them (34% vs. 55%, odds ratio=0.432, 95% confidence interval=0.300–0.622, P<0.001).
  • However, the incidence of nausea or vomiting was similar regardless of prophylactic medication with dopamine D2 blockers.
  • The results of the meta–analysis revealed that prophylactic laxatives significantly reduced the incidence of constipation (overall odds ratio=0.469, 95% confidence interval=0.231–0.955, P=0.037), whereas dopamine D2 blockers were not effective in preventing opioid–induced nausea or vomiting.

Please login or register to follow this author.
Are you sure you want to Unfollow this Author?
► Click here to access PubMed, Publisher and related articles...
<< Previous Article | Next Article >>

Your Unread Messages in Internal Medicine

See All >> Messages include industry-sponsored communications and special communications from MDLinx

Most Popular Internal Medicine Articles

1 Corticosteroid treatment for community-acquired pneumonia - the STEP trial: study protocol for a randomized controlled trial Full Text Trials, July 16, 2014    Free full text    Evidence Based Medicine    Clinical Article

2 Screening pelvic examinations in asymptomatic, average-risk adult women: An evidence report for a clinical practice guideline from the American college of physicians Annals of Internal Medicine, July 2, 2014    Evidence Based Medicine    Clinical Article

3 Efficacy of varenicline combined with nicotine replacement therapy vs varenicline alone for smoking cessation: A randomized clinical trial JAMA, July 10, 2014    Evidence Based Medicine    Clinical Article

4 Buprenorphine treatment for hospitalized, opioid-dependent patients: a randomized clinical trial JAMA Internal Medicine, July 15, 2014    Evidence Based Medicine    Clinical Article

5 Statins and physical activity in older men the osteoporotic fractures in men study JAMA Internal Medicine, June 12, 2014    Evidence Based Medicine    Clinical Article

6 Helicobacter pylori eradication therapy to prevent gastric cancer in healthy asymptomatic infected individuals: systematic review and meta-analysis of randomised controlled trials BMJ, June 11, 2014    Evidence Based Medicine    Clinical Article

7 Challenges of infectious diseases in the USA The Lancet, July 3, 2014    Review Article    Clinical Article

8 Vitamin D and Calcium Supplementation to Prevent Fractures in Adults: U.S. Preventive Services Task Force Recommendation Statement Full Text Annals of Internal Medicine, February 26, 2013    Free full text    Clinical Guideline

9 Avoidance of sun exposure is a risk factor for all-cause mortality: results from the MISS cohort Journal of Internal Medicine, April 22, 2014    Evidence Based Medicine    Clinical Article

10 Association between melanocytic nevi and risk of breast diseases: The French E3N Prospective Cohort Full Text PLoS Medicine, July 1, 2014    Free full text    Evidence Based Medicine    Clinical Article

11 Thrombolysis for pulmonary embolism and risk of all-cause mortality, major bleeding, and intracranial hemorrhage: A meta-analysis JAMA, June 26, 2014    Evidence Based Medicine    Clinical Article

12 Once-weekly dulaglutide versus once-daily liraglutide in metformin-treated patients with type 2 diabetes (AWARD-6): a randomised, open-label, phase 3, non-inferiority trial The Lancet, July 25, 2014    Evidence Based Medicine    Clinical Article

13 Changes in circulating leptin levels during acute stress and associations with craving in abstinent smokers: A preliminary investigation Psychoneuroendocrinology, June 20, 2014    Clinical Article

14 CPAP, weight loss, or both for obstructive sleep apnea New England Journal of Medicine, June 13, 2014    Evidence Based Medicine    Clinical Article

15 Treatment of venous thromboembolism Full Text JAMA, February 19, 2014    Free full text    Evidence Based Medicine    Clinical Article

16 Tea consumption and leukemia risk: A meta-analysis Tumor Biology, February 12, 2014    Evidence Based Medicine    Clinical Article

17 Glycated hemoglobin measurement and prediction of cardiovascular disease JAMA, March 26, 2014    Evidence Based Medicine

18 Many sudden cardiac arrests preceded by warning signs Circulation, November 20, 2013    Evidence Based Medicine    Clinical Article

19 Risk of pediatric celiac disease according to HLA haplotype and country New England Journal of Medicine, July 7, 2014    Evidence Based Medicine    Clinical Article

20 Resveratrol levels and all-cause mortality in older community-dwelling adults JAMA Internal Medicine, May 13, 2014    Evidence Based Medicine    Clinical Article

Indexed Journals in Internal Medicine: New England Journal of Medicine, The Lancet, Archives of Internal Medicinemore

Register now to view all the MDLinx contents (FREE)!

  • Stay current on the latest literature, research and clinical news
  • Get special communications and offers from MDLinx and our sponsors
  • Receive invitations to paid market research
View Samples and Register

Connect with us, stay current.

Receive the latest mecial news
updates for free via email

Sign up!

Subscribe to our free RSS feeds:

Get the latest news in your specialty automatically added to your newsreader or your personal My Yahoo!, Google, My MSN or My AOL page. Learn More

Close