The use of naloxone for the treatment of opioid-induced constipation (OIC)

Background: Opioid-induced constipation (OIC) is a major problem that can have a significant impact on a patient’s quality of life (QoL). The use of opioids for both long and short term analgesia has been the standard treatment for many years. All opioids, like oxycodone, can be connected with the development of bowel dysfunction, with constipation being one of the more frequently reported adverse effects. Many of the standard methods and protocols that hospitals use seem to have little effect on this continuing problem. Hypothesis: That the use of oral naloxone Prolonged Release (PR), in conjunction with oxycodone PR, will improve patient bowel function, without effecting analgesia or creating additional side effects that decrease patients’ QoL. Study Design: Exhaustive search of available medical literature. Methods: The intent of this study was to seek out and review the most current literature available on this problem utilizing a minimum of three search engines. The review of literature was limited to Randomized Control Trials (RCT) published since 2008. Results: five studies were found that met the criteria for inclusion in this review. Two of the five were based upon the same data although with separate clinical questions. Conclusion: The studies showed that naloxone PR, when given to a patient who is established on a stable dose of oxycodone PR, significantly improved the patients’ bowel function, without adding additional adverse events, causing opioid withdrawal or decreasing analgesic properties, and that the optimum ratio which produced the leased number of adverse events was 2:1. Degree Type Capstone Project Rights Terms of use for work posted in CommonKnowledge. This capstone project is available at CommonKnowledge: http://commons.pacificu.edu/pa/174 Copyright and terms of use If you have downloaded this document directly from the web or from CommonKnowledge, see the “Rights” section on the previous page for the terms of use. If you have received this document through an interlibrary loan/document delivery service, the following terms of use apply: Copyright in this work is held by the author(s). You may download or print any portion of this document for personal use only, or for any use that is allowed by fair use (Title 17, §107 U.S.C.). Except for personal or fair use, you or your borrowing library may not reproduce, remix, republish, post, transmit, or distribute this document, or any portion thereof, without the permission of the copyright owner. [Note: If this document is licensed under a Creative Commons license (see “Rights” on the previous page) which allows broader usage rights, your use is governed by the terms of that license. ] Inquiries regarding further use of these materials should be addressed to: CommonKnowledge Rights, Pacific University Library, 2043 College Way, Forest Grove, OR 97116, (503) 352-7209. Email inquiries may be directed to:. copyright@pacificu.edu This capstone project is available at CommonKnowledge: http://commons.pacificu.edu/pa/174 NOTICE TO READERS This work is not a peer-reviewed publication. The Master’s Candidate author(s) of this work have made every effort to provide accurate information and to rely on authoritative sources in the completion of this work. However, neither the author(s) nor the faculty advisor(s) warrants the completeness, accuracy or usefulness of the information provided in this work. This work should not be considered authoritative or comprehensive in and of itself and the author(s) and advisor(s) disclaim all responsibility for the results obtained from use of the information contained in this work. Knowledge and practice change constantly, and readers are advised to confirm the information found in this work with other more current and/or comprehensive sources. The student authors attest that this work is completely their original authorship and that no material in this work has been plagiarized, fabricated or incorrectly attributed.