Opiate-Induced Bowel Dysfunction

Published Online: Tuesday, November 1, 2005

Opiate-induced bowel dysfunction can pose a significant clinical problem. Jonathan Gonenne, MD, and colleagues evaluated the effects of alvimopan, a peripheral mu-opioid antagonist, on codeine-induced delays in gastric, small bowel, and colonic transit time in healthy volunteers (43 women, 31 men). In a double-blinded study, patients were randomized to 1 of 4 groups: alvimopan 12 mg bid with or without codeine sulfate 30 mg 4 times/day, codeine alone, or placebo alone. Gastric emptying and small bowel and colonic transit were measured by scintigraphy.

Primary end points for colonic transit were geometric center (GC) of the colonic counts at 24 hours and time for 50% ascending colon emptying. Codeine delayed gastric, small bowel, proximal, and overall colonic transit (P < .05). Alvimopan reversed the effect of codeine on small bowel and colon (ascending colon and overall colonic transit) and accelerated overall colonic transit, compared with placebo (GC 24 hours, P < .05). Alvimopan did not reverse the codeineinduced delay of gastric emptying (Clinical Gastroenterology and Hepatology, August 2005).

Latest Articles
Beverly Schaefer, RPh, of Katterman's Sand Point Pharmacy in Seattle, Washington, shares some fun tips on how to encourage patients who travel to come to your pharmacy for supplies.
Donnie Calhoun, RPh, PD, National Community Pharmacists Association (NCPA) Foundation vice president, discusses how pharmacists can prepare themselves and their business before, during, and after a disaster.
Ken Whittemore Jr, Surescript's senior vice president of professional and regulatory affairs, talks about some new transactions available that can help pharmacists.
In case you got caught up in the Thanksgiving holiday rush, here are the top trending stories you may have missed in November:
Latest Issues