Handbook of Opioid Bowel Syndrome  book cover
1st Edition

Handbook of Opioid Bowel Syndrome

ISBN 9780789021298
Published August 25, 2005 by CRC Press
276 Pages

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Book Description

How can medical professionals take advantage of the valuable effects of opiates while minimizing their most common side effect—opioid bowel syndrome?

This groundbreaking book will help physicians in their day-to-day practice and help researchers and educators prepare the next generation of clinicians to make more efficient use of opioids. The Handbook of Opioid Bowel Syndrome presents complete, authoritative, current information on the mechanisms of action of opioids and the management of opioid bowel dysfunction-the number one reason physicians avoid prescribing opioids. Most chapters include charts, tables, and/or illustrations that make complex information about this vexing problem easy to access and understand. All are well-referenced for further study.

From the editor: “Opioid compounds, which are widely administered for a variety of medical indications, are associated with a number of side effects, especially opioid bowel dysfunction (OBD). Very often, OBD is so severe that physicians limit opioid use or dose, even when medically indicated. Although OBD is a significant clinical problem, it has received insufficient attention in the past within the medical community. This book presents complete, authoritative information on recent progress in understanding the mechanisms of action of opioids in relation to OBD and its management.”

In 11 well-referenced chapters, the Handbook of Opioid Bowel Syndrome addresses:

  • gastrointestinal opioid physiology and pharmacology
  • the pathophysiology of opioid-induced bowel dysfunction
  • the epidemiology of OBD
  • OBD in palliative care
  • OBD in acute and chronic nonmalignant pain
  • post-operative OBD
  • post-surgical bowel dysfunction in the gynecological patient
  • new peripheral opioid antagonists currently under clinical development
Packed with information about opioids that was previously unavailable or difficult to find, the Handbook of Opioid Bowel Syndrome is an essential addition to the library of any clinician, researcher, or educator who needs current, essential knowledge about the best ways to utilize these quality-of-life enhancing medications.

Table of Contents

  • About the Editor
  • Contributors
  • Preface
  • Introduction (Chun-Su Yuan and Marco Pappagallo)
  • Chapter 1. Gastrointestinal Opioid Physiology and Pharmacology (Keri L. Fakata and Arthur G. Lipman)
  • Gastrointestinal Physiology
  • Opioid Effects on the Gastrointestinal System
  • Exogenous Opioid Effects on the Gastrointestinal System
  • Chapter 2. Pathophysiology of Opioid-Induced Bowel Dysfunction (Sangeeta R. Mehendale and Chun-Su Yuan)
  • Gastrointestinal Dysfunction Caused by Exogenous Opioids
  • Role of Endogenous Opioids in Normal and Impaired Gut Function
  • Chapter 3. Opioid-Induced Immunosuppression (Gang Wei, Jonathan Moss, and Chun-Su Yuan)
  • Studies of Opioid-Induced Immunosuppression
  • Is Opioid-Induced Immunosuppression Centrally Mediated?
  • Is Opioid-Induced Immunosuppression Peripherally Mediated?
  • Summary and Future Work
  • Chapter 4. The Epidemiology of Opioid Bowel Dysfunction (Ysmael Yap and Marco Pappagallo)
  • Introduction
  • Gastrointestinal Adverse Effects of Opioids
  • Prevalence in the General Population
  • Prevalence in the Opioid-Treated Population
  • Discussion
  • Chapter 5. Opioid Bowel Dysfunction in Palliative Care (Nigel P. Sykes)
  • Introduction
  • Constipation
  • Evaluation of Constipation
  • Management
  • Nausea and Vomiting
  • Conclusion
  • Chapter 6. Opioid Bowel Dysfunction in Acute and Chronic Nonmalignant Pain (Keri L. Fakata, Ashok K. Tuteja, and Arthur G. Lipman)
  • Introduction
  • Differentiating Pain Types
  • Opioid Bowel Dysfunction in Acute Pain
  • Opioid Bowel Dysfunction in Chronic Nonmalignant Pain
  • Is Opioid Bowel Dysfunction Properly Addressed in These Populations?
  • Current Treatment Options for Opioid Bowel Dysfunction
  • Conclusion
  • Chapter 7. Postoperative Bowel Dysfunction (Cormac Fahy and Tong J. Gan)
  • Introduction
  • Pathogenesis of Postoperative Ileus
  • Contribution of Perioperative and Postoperative Opioids
  • Role of General Anesthesia in Postoperative Bowel Dysfunction
  • Therapy of Postoperative Bowel Dysfunction
  • Conclusions
  • Chapter 8. Postsurgical Bowel Dysfunction in the Gynecologic Patient (Eric J. Bieber)
  • Introduction
  • Pathophysiology
  • Bowel Function After Hysterectomy
  • Effect of Early Feedings and NG Use on Bowel Function
  • Epidurals, General Anesthesia, and Patient-Controlled Analgesia
  • Opioid Antagonists
  • Conclusion
  • Chapter 9. Using Oral Naloxone in Management of Opioid Bowel Dysfunction (Nigel P. Sykes)
  • Evidence for a Peripheral Site of Opioid Constipating Action
  • Naloxone As an Opioid Antagonist
  • The Use of Naloxone for Treatment of Opioid-Induced Constipation
  • Discussion of Reported Clinical Studies
  • Use of Oral Naloxone for Idiopathic Constipation
  • Discussion of Reported Studies of Naloxone for Idiopathic Constipation
  • Chapter 10. Methylnaltrexone: Investigations in Treating Opioid Bowel Dysfunction (Thomas A. Boyd and Chun-Su Yuan)
  • Receptor-Binding Studies
  • Preclinical Studies
  • Absorption, Elimination, and Metabolism
  • Safety and Tolerance Studies in Humans
  • Efficacy Studies
  • Summary
  • Chapter 11. Management of Opioid-Induced Bowel Dysfunction and Postoperative Ileus: Potential Role of Alvimopan (Joseph F. Foss and William K. Schmidt)
  • Introduction
  • Preclinical Development
  • Clinical Development
  • Summary
  • Index
  • Reference Notes Included

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