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Issues in Palliative Care Research$
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Russell K. Portenoy and Eduardo Bruera

Print publication date: 2003

Print ISBN-13: 9780195130652

Published to Oxford Scholarship Online: November 2011

DOI: 10.1093/acprof:oso/9780195130652.001.0001

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Assessment of Novel Therapies for Constipation: Focus on Opioid Analgesics

Assessment of Novel Therapies for Constipation: Focus on Opioid Analgesics

(p.41) 3 Assessment of Novel Therapies for Constipation: Focus on Opioid Analgesics
Issues in Palliative Care Research

Russell K. Portenoy

Eduardo Bruera

Oxford University Press

Pain control is a primary goal of palliative care. The World Health Organization (WHO) guidelines for pain control specify an escalating series of therapies, but the ultimate resource for the control of severe pain remains the opioids. Forty to forty-five percent of patients presenting for hospice care complain of constipation on admission. Work is needed to define the mechanisms by which opioids produce constipation. The secondary effects of opioid receptor activation also may be further defined and present new opportunities for pharmacological intervention. Those developing opioid alternatives, especially opioids with differing receptor affinities, have been unable to separate the analgesic properties from the side effects of opioids. Methods to optimize opioid use and traditional bowel care methods are being examined, but it is difficult at times to compare the results of interventions as the model and definition of success vary widely between publications.

Keywords:   pain control, palliative care, World Health Organization, bowel care, pharmacological intervention, receptor affinities

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