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.
► 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 Effects of tea intake on blood pressure: A meta-analysis of 21 randomized controlled trials JACC - Journal of the American College of Cardiology, October 22, 2014    Clinical Article

2 Cost-effectiveness of CT screening in the national lung screening trial New England Journal of Medicine, November 7, 2014    Evidence Based Medicine    Clinical Article
Exclusive Author Commentary

3 Effects of hyperbaric oxygen on symptoms and quality of life among service members with persistent postconcussion symptoms: a randomized clinical trial JAMA Internal Medicine, November 21, 2014    Evidence Based Medicine    Clinical Article

4 Sweetened carbonated beverage consumption and cancer risk: Meta-analysis and review European Journal of Cancer Prevention, August 1, 2014    Evidence Based Medicine    Review Article

5 The burden of disease in older people and implications for health policy and practice The Lancet, November 12, 2014    Evidence Based Medicine    Clinical Article

6 How World War 1 changed global attitudes to war and infectious diseases The Lancet, November 10, 2014    Evidence Based Medicine    Clinical Article

7 The causal effect of vitamin D binding protein (DBP) levels on calcemic and cardiometabolic diseases: a Mendelian randomization study Full Text PLoS Medicine, November 4, 2014    Free full text    Evidence Based Medicine    Clinical Article

8 Efficacy of a tetravalent dengue vaccine in children in Latin America New England Journal of Medicine, November 6, 2014    Evidence Based Medicine    Clinical Article

9 Sodium zirconium cyclosilicate in hyperkalemia New England Journal of Medicine, November 26, 2014    Evidence Based Medicine    Clinical Article

10 Changes in patients' experiences in medicare accountable care organizations New England Journal of Medicine, November 3, 2014    Evidence Based Medicine    Clinical Article

11 Milk intake and risk of mortality and fractures in women and men: cohort studies BMJ, November 11, 2014    Evidence Based Medicine    Clinical Article

12 Acupuncture for chronic knee pain: a randomized clinical trial JAMA, October 1, 2014    Evidence Based Medicine    Clinical Article

13 Nonobstructive coronary artery disease and risk of myocardial infarction JAMA, November 6, 2014    Evidence Based Medicine    Clinical Article

14 Evaluation and treatment of older patients with hypercholesterolemia: A clinical review JAMA, October 20, 2014    Clinical Article

15 Effects of vaccination on invasive pneumococcal disease in South Africa New England Journal of Medicine, November 19, 2014    Evidence Based Medicine    Clinical Article

16 Three-year denosumab treatment in postmenopausal Japanese women and men with osteoporosis: Results from a 1-year open-label extension of the Denosumab Fracture Intervention Randomized Placebo Controlled Trial (DIRECT) Osteoporosis International, November 25, 2014    Evidence Based Medicine    Clinical Article

17 An interferon-free antiviral regimen for HCV after liver transplantation New England Journal of Medicine, November 13, 2014    Evidence Based Medicine    Clinical Article

18 Aspirin in type 2 diabetes, a randomised controlled study: effect of different doses on inflammation, oxidative stress, insulin resistance and endothelial function International Journal of Clinical Practice, December 27, 2013    Clinical Article

19 Non-psychotic mental disorders in the perinatal period The Lancet, November 20, 2014    Evidence Based Medicine    Clinical Article

20 Oral contraceptive use and mortality after 36 years of follow-up in the Nurses' Health Study: prospective cohort study BMJ, November 7, 2014    Evidence Based Medicine    Clinical Article

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