Chapter

Assessment of Novel Therapies for Constipation: Focus on Opioid Analgesics

Russell K. Portenoy and Eduardo Bruera

in Issues in Palliative Care Research

Published in print September 2003 | ISBN: 9780195130652
Published online November 2011 | e-ISBN: 9780199999842 | DOI: http://dx.doi.org/10.1093/acprof:oso/9780195130652.003.0003
Assessment of Novel Therapies for Constipation: Focus on Opioid Analgesics

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Pain control is a primary goal of palliative care. The World Health Organization (WHO) guidelines for pain control specify an escalating series of therapies, but the ultimate resource for the control of severe pain remains the opioids. Forty to forty-five percent of patients presenting for hospice care complain of constipation on admission. Work is needed to define the mechanisms by which opioids produce constipation. The secondary effects of opioid receptor activation also may be further defined and present new opportunities for pharmacological intervention. Those developing opioid alternatives, especially opioids with differing receptor affinities, have been unable to separate the analgesic properties from the side effects of opioids. Methods to optimize opioid use and traditional bowel care methods are being examined, but it is difficult at times to compare the results of interventions as the model and definition of success vary widely between publications.

Keywords: pain control; palliative care; World Health Organization; bowel care; pharmacological intervention; receptor affinities

Chapter.  4519 words. 

Subjects: Palliative Medicine

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