Saini Harneel S, Alvi Zara, Singh Bavandeep, Elsharkawy Basant, Yasir Muhammad
Neurology, Allegheny General Hospital, Pittsburgh, USA.
Internal Medicine, Allegheny Health Network, Pittsburgh, USA.
Cureus. 2020 Jan 31;12(1):e6829. doi: 10.7759/cureus.6829.
Opioid antagonists in the ICU are often a last-line medication given to patients with opioid-induced constipation. Traditionally, patients have been administered nonopioid-based bowel regimens such as senna, peg, and docusate to treat constipation. Despite the obvious need to treat acute pain with opioids, side effects such as constipation can lead to multiple gastrointestinal (GI) complications such as bowel perforation and even death. Specifically, opioid-induced constipation (OIC) can be very difficult to treat. We examine naloxone and methylnaltrexone (MNTX) assessing GI complications and OIC as well as present a patient case which highlights the importance of treating OIC. We also evaluate the superior reversal agent of choice when treating OIC in the critical care and stepdown unit settings.
重症监护病房（ICU）中的阿片类拮抗剂通常是用于治疗阿片类药物引起便秘患者的最后一线药物。传统上，一直给患者使用基于非阿片类药物的肠道治疗方案，如番泻叶、聚乙二醇和多库酯来治疗便秘。尽管明显需要用阿片类药物治疗急性疼痛，但便秘等副作用可能导致多种胃肠道（GI）并发症，如肠穿孔甚至死亡。具体而言，阿片类药物引起的便秘（OIC）可能很难治疗。我们研究纳洛酮和甲基纳曲酮（MNTX），评估胃肠道并发症和OIC，并展示一个突出治疗OIC重要性的患者病例。我们还评估在重症监护和降级护理病房环境中治疗OIC时首选的更有效的逆转剂。
