The purpose of this study was to determine the safety and tolerability of naloxegol in patients who experience opioid-induced constipation (OIC) and suffer from noncancer pain. This was done through a phase 3 clinical trial that was performed over 52 weeks and across multiple centers with parallel groups. The trial was open-labeled, and patients were randomized 2:1 to receive either naloxegol 25 mg once daily or the usual care treatment regimen prescribed by the investigator at his discretion. The patients ranged from ages 18-65 years old and were receiving 30-1000 morphine-equivalent units (MEUs) with confirmed OIC over a 2-week period. 327 out of the 563 patients (58%) in the naloxegol group completed the study, and 189 out of the 281 patients (67%) in the usual care group completed the study. The primary objective of this study was the safety and tolerability of naloxegol, and the secondary objective of this study was the safety profile of naloxegol compared to the usual care laxative regimen. …show more content…
In the naloxegol group, 81.8% of patients experienced an adverse event (AE), 9.6% experienced a serious AE, and 10.5% experienced an AE that resulted in discontinuation of the product. In the usual care group, 72.2% of patients experienced an AE, and 11.1% experienced a serious AE. In this group, patients could switch to a different usual care treatment option at any time during the study, so data for discontinuation due to AE is not applicable. It was determined that there needed to be over 300 patients in the naloxegol group and over 100 patients in the usual care group. Both of these requirements were
5Opioids increase the tone and decrease contractions of smooth muscle in the GI tract. The transit time that fentanyl causes, may be responsible for its constipating effect. The increase in biliary tract pressure, some patients may experience worsening of pain rather than pain relief. Fentanyl may cause orthostatic hypotension and fainting.5
This is being done in hopes to decrease the number of overdose deaths that are occurring in West Virginia. The law does have restrictions. Those who buy naloxone OTC must be trained by a pharmacist on how to recognize an overdose, when to administer the antidote, and how to properly inject or inhale the drug. Pharmacies must also provide educational material telling customers how and where to access treatment programs (Brown, A., Para. 1, 2016). West Virginia being the number one state in overdose deaths, I personally believe that it is a good decision to pass this law. However, I think people should be trained properly on how to administer, when to administer, what to do, what signs to look for and how to respond. Narcan is a life savior and it should be readily available over the counter. Just because they have addiction or uses drug, they don’t deserve to die. If there is already a drug to save someone’s lives, why not use it. It is ridiculous how expensive the drug cost compared to other countries. Lower class and middle class people cannot afford to buy a drug for 500 to 600 dollars. I think it is a control by the big drug industries to make more money but being greedy is just hurting everyone. If country like Australia and Canada can sell cheap as a dollar, how come it costs 500-600 dollars in USA. People have stereotype belief that only druggies gets overdosed. However, it is not true. Older people who sometimes forget what medicines they took, light weight people who had never taken any drugs when started on pain medicines because of accidents or even though if it is overdose by someone trying to get high, saving life is a miracle. With the scientific achievement, people can make clone, skin graft, synthetic valves or many ways to save or repair human body, but no one can bring a soul back to a dead body. Many people doesn’t get overdosed to kill
Multiple studies have demonstrated the prophylactic effect of rectal declophenate (5-9) and rectal indomethacin (10, 11) or combined diclophenate and indomethacin (12), but no studies have evaluated the prophylactic effect of oral NSAIDs. On the other hand, Almeida et al demonstrated data on the ...
What is the purpose of each of the medications the patient is on? Why is this patient receiving them?
Almost one hundred years ago, prescription drugs like morphine were available at almost any general store. Women carried bottles of very addictive potent opiate based pain killers in their purse. Many individuals like Edgar Allen Poe died from such addictions. Since that time through various federal, state and local laws, drugs like morphine are now prescription drugs; however, this has not stopped the addiction to opiate based pain killers. Today’s society combats an ever increasing number of very deadly addictive drugs from designer drugs to narcotics to the less potent but equally destructive alcohol and marijuana. With all of these new and old drugs going in and out of vogue with addicts, it appears that the increase of misuse and abuse is founded greater in the prescription opiate based painkillers.
Opioids are used as pain relievers and although it does the job, there are adverse side effects. Opioids are frequently used in the medical field, allowing doctors to overprescribe their patients. The substance can be very addicting to the dosage being prescribed to the patient. Doctors are commonly prescribing opioids for patients who have mild, moderate, and severe pain. As the pain becomes more severe for the patient, the doctor is more likely to increase the dosage. The increasing dosages of the narcotics become highly addicting. Opioids should not be prescribed as pain killers, due to their highly addictive chemical composition, the detrimental effects on opioid dependent patients, the body, and on future adolescents. Frequently doctors have become carless which causes an upsurge of opioids being overprescribed.
According to CDC in the year 2015 opioids played a part in 33,091 deaths. Now you may ask what an opioid is. An Opioid is a compound that binds to opioid receptors in the body to reduce the amount of pain. There are four main categories of opioids, one being natural opioid analgesics including morphine and codeine, and semi synthetic opioid analgesics, including oxycodone, hydrocodone, hydromorphone, and oxymorphone. The second category being methadone, a synthetic opioid, the third category being synthetic opioid analgesics other than methadone includes tramadol and fentanyl. The last category is an illicit opioid that is synthesized from morphine called heroin.
Opiates are a class of drugs that are used for chronic pain. Opioids are substances that are used to relieve pain by binding opiate receptors throughout the body, and in the brain. These areas in the brain control pain and also emotions, producing a feeling of excitement or happiness. As the brain gets used to these feelings, and the body builds a tolerance to the opioids, there is a need for more opioids and then the possibility of addiction.
Morphine has been used for many years in different cultures, and for different reasons. It has been abused, demolished, revived, and manufactured. It has saved many lives and ruined many more. It is the drug of choice for many who feel they need something to numb out the bad, and forget about the real. It is also the prescription of choice for men and women who just want to have their lives back. Although morphine addicts go through hell during their withdrawal stages, and how awful the drug can be through abuse, it offers very much to a wide array of patients suffering from diseases such as cancer, severe back pain, kidney stones, and pain associated in trauma.
As we age, the use of medication is often increased in an effort to treat illness and disease. In older adults this frequently results in the administration of multiple medications, both appropriately and inappropriately, at the same time. This is known as polypharmacy. While polypharmacy can exist with any age demographic, it is much more prevalent in older adults where the risk of multiple health conditions is greater. It is not uncommon, for example, for a patient to be treated with multiple therapeutic drug combinations in order to manage disease such as diabetes, heart failure and chronic obstructive pulmonary disease (Kaufman, 2011, p. 49). Polypharmacy is associated as a major factor placing older adults at risk for an adverse drug event. As the number of medications increase, the need for monitoring becomes much more crucial. When there is a breakdown in proper monitoring, the older adult is significantly placed at a higher risk for negative health outcomes due to serious side effects, poor adherence, adverse drug reactions and adverse drug interactions.
Effective treatment of cancer pain is essential for ensuring the best outcomes for cancer patients, in terms of physical, psychological and social aspects. Although there are no NICE guidelines for management of cancer pain, WHO guidance should be used to inform clinical practice. Careful assessment is a critical element of the process to ensure that patients are offered the treatment which is likely to offer the best outcomes, yet without providing a greater than necessary risk of complications such as tolerance and addiction to opioids. The main outcome that this paper highlights is that “Pain is what the patient says it is and exists when he says it does” (McCaffery 1983
...d a gap in the number of studies conducted regarding this issue. From the studies reviewed, the results demonstrate that the increasingly health related issue of polypharmacy among the elderly requires the immediate attention of health care professionals. The studies revealed that in conjunction with medication reviews (brown bag), the STOPP criteria is a tool in which can be effective in detecting PIMs. The studies also revealed that nurses are in the position to address and assess for adverse drug reactions associated with polypharmacy by utilizing the “brown bag”, medication review, and STOPP criteria. Regarding the PICO question, the results of these studies support the essential need of medication reviews to be implemented by nurses and healthcare professionals at every provider visit to reduce the risk of polypharmacy and its associated adverse reactions.
Polypharmacy among the elderly is a growing concern in U.S. healthcare system. Elderly who have comorbities and take multiple medications are at a higher risk for potential adverse drug reactions. Elderly who take over-the-counter medications, herbs, and supplements without consulting their physician are at risk for adverse reactions associated with polypharmacy. Polypharmacy can result from patients having multiple prescribers and pharmacies, and patients who continue to take medications which have been discontinued by the physician. There is a great need for nursing interventions regarding polypharmacy, including medication reviews also known as “brown bag”. As nurses obtain history data and conduct a patient assessment, it is essential to review the patients’ medications and ask open-ended questions regarding all types of medications in which the patient is taking. In addition, the patient assessment is also an opportunity for the nurse to inquire about any adverse reactions the patient may be experiencing resulting from medications. Nurses are in a unique position to provide early detection and intervention for potentially inappropriate medications and its associated adverse drug reactions.
Potent pain medication contains the aspects of utilizing medications such as morphine or demerol, how the medications are dispensed, and t...
Aranella, Cheryl, MD., M.P.H. Use of Opiates to Manage Pain in the Seriously and Terminally Ill Patient. American Hospice Foundation, 2006. Web. 7 November 2011.