Subcutaneous methylnaltrexone to restore postoperative bowel function in a long-term opiate user

International Journal of Gynecological Cancer : Official Journal of the International Gynecological Cancer Society
Andras LadanyiJonathan Moss

Abstract

One of the most common undesired effects of analgesic opioid use and addiction is constipation. Numerous pharmacologic agents have been used to treat opioid-induced bowel hypomotility with limited success. Methylnaltrexone bromide (MNTX) selectively targets the peripheral adverse effects of opioids while preserving the central analgesic effects of opioid agonist treatment. While it is indicated for use in nonsurgical patients in the palliative care setting, here we report the use of MNTX for the alleviation of postoperative ileus in a heroin user with recurrent cervical cancer undergoing diverting colostomy and urinary conduit placement. Results suggest that MNTX may accelerate postoperative gastrointestinal recovery in opioid-dependent patients. Further studies are warranted to evaluate its role in the pharmacologic management of postoperative ileus.

References

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Aug 22, 2007·Diseases of the Colon and Rectum·Miranda K Y Chan, Wai Lun Law
May 30, 2008·The New England Journal of Medicine·Jay ThomasRobert J Israel
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Oct 3, 2008·Mayo Clinic Proceedings·Jonathan Moss, Carl E Rosow
Oct 8, 2008·Palliative Medicine·P J LarkinUNKNOWN European Consensus Group on Constipation in Palliative Care

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