Year 2020 / Volume 27 / Number 1

Review

Peripheral acting Mu opioid receptor antagonists in the treatment of the opioid-induced constipation: review

Rev. Soc. Esp. Dolor. 2020; 27(1): 37-49 / DOI: 10.20986/resed.2020.3717/2018

Anna Libran Oriol, Claudia Cruz-Sequeiros, Ana Luque-Blanco, Josep Porta-Sales


ABSTRACT

The opioid induced constipation (OIC) is an emerging clinical problems that worsen the patients’ quality of life requiring opioids for their pain relief. Many drugs have been launched as Peripheral Acting Mu Opioid Receptor Antagonists o PAMORAs (metylnaltrexone, alvimopam and more recently naloxegol), which antagonize the peripheral effects of opioids without affecting the opioids analgesia. Metylnaltrenone and naloxegol have been licensed for the treatment of CIO, meanwhile alvimopam is approved for the recovery of postoperative ileus after major abdominal surgery. All PAMORAs have shown clinical efficacy but is a matter of debate wich should be their role in the manangement of the CIO. The available information about PAMORAs is reviewed and informed strategy on the use of these drugs is proposed.



RESUMEN

El estreñimiento inducido por opioides (EIO) constituye un problema clínico emergente que empeora la calidad de vida de los pacientes que requieren el uso de opioides para el manejo del dolor. Diferentes fármacos se han comercializado como antagonistas de los receptores opioides Mu periféricos, conocidos con el nombre de Peripheral Acting Mu Opioid Receptor Antagonists o PAMORA (metilnaltrexona, alvimopam y más recientemente naloxegol), que permiten la antagonización de los efectos periféricos de los opioides sin interferir en su efecto analgésico. Tanto metilnaltrexona como naloxegol han sido aprobados para el tratamiento del EIO, mientras que alvimopan está aprobado para la recuperación gastrointestinal después de resección intestinal con anastomosis primaria. Todos ellos han mostrado su eficacia clínica, pero es debatido el papel que han de tener en la estrategia global del manejo del EIO. Se revisa la información disponible sobre los PAMORA y se propone estrategia de uso clínico.





Complete Article

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Prevalence of breakthrough pain associated with chronic low back pain in Andalusia (COLUMBUS study)

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Instrucciones para citar

Libran Oriol A, Cruz-Sequeiros C, Luque-Blanco A, Porta-Sales J. Peripheral acting Mu opioid receptor antagonists in the treatment of the opioid-induced constipation: review. Rev Soc Esp Dolor 2020; 27(1): 37-49 / DOI: 1020986/resed20203717/2018


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Recibido: 11/12/2018

Aceptado: 13/01/2020

Prepublicado: 15/01/2020

Publicado: 19/02/2020

Tiempo de revisión del artículo: 356 días

Tiempo de prepublicación: 400 días

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© 2020 Revista de la Sociedad Española del Dolor
ISSN: 1134-8046   e-ISSN: 2254-6189

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