Opioid-induced constipation in palliative care: state of the art          /      Constipação induzida por opióides em cuidado paliativo: o estado da arte

Erlania do Carmo Freitas; Geslaney Reis da Silva; Rudval Souza da Silva; Rita Narriman Silva de Oliveira Boery; Maria Patricia Milagres

doi:10.9789/2175-5361.rpcfo.v12.8008

Autores/as

Erlania do Carmo Freitas Universidade Estadual do Sudoeste da Bahia - UESB http://orcid.org/0000-0002-8115-5041
Geslaney Reis da Silva Universidade Estadual do Sudoeste da Bahia http://orcid.org/0000-0003-0613-0538
Rudval Souza da Silva http://orcid.org/0000-0002-7991-8804
Rita Narriman Silva de Oliveira Boery Universidade Estadual do Sudoeste da Bahia - UESB http://orcid.org/0000-0002-7823-9498
Maria Patricia Milagres Universidade Estadual do Sudoeste da Bahia - UESB http://orcid.org/0000-0002-4845-5624

DOI:

https://doi.org/10.9789/2175-5361.rpcfo.v12.8008

Palabras clave:

Morfina, Constipação, Cuidados paliativos, Enfermagem e saúde, Nutrição

Resumen

OBJECTIVE: The study’s purpose has been to address the state of the art in investigations such as clinical trials, systematic reviews with meta-analysis and case studies, which report how to minimize opioid-induced constipation in patients undergoing palliative care. METHODS: This is an exploratory study through an integrative review of four databases addressing published articles from 2013 to 2017. RESULTS: A total of 117 publications were presented, which 17 presented the inclusion criteria. The studies describe the prevalence of constipation rates induced by the use of opioids. CONCLUSION: Although these drugs alleviate pain, the adverse reactions may generate discomfort and loss of the patient’s life quality. There are limited data on the treatment of constipation. It was observed that few authors mentioned diet as a helper on this situation, emphasizing the use of medications. Further studies should be encouraged aiming to find the balance between analgesia and reduction of adverse effects.

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Biografía del autor/a

Erlania do Carmo Freitas, Universidade Estadual do Sudoeste da Bahia - UESB

Nutricionista, doutoranda em Enfermagem e Saúde - UESB

Geslaney Reis da Silva, Universidade Estadual do Sudoeste da Bahia

Enfermeiro. Mestre em Ciências da Saúde pelo Programa de Pós-Graduação em Enfermagem e Saúde, Universidade Estadual do Sudoeste da Bahia (UESB).

Rita Narriman Silva de Oliveira Boery, Universidade Estadual do Sudoeste da Bahia - UESB

Professora pleno, Doutora do programa de pós-graduação em Enfermagem e saúde

Maria Patricia Milagres, Universidade Estadual do Sudoeste da Bahia - UESB

Doutora Professora Adjunta da Universidade Estadual do Sudoeste da Bahia - UESB

Citas

Organização Mundial da Saúde. Alívio da dor do câncer. 2ª ed. Genebra: Organização Mundial da Saúde.[Internet]. 1996 [Citado 2018 Out. 10]. Available from:http://apps.who.int/iris/bitstream/10665/37896/1/9241544821.pdf

Caraceni A, Hanks G, Kaasa S, Bennett MI, Brunelli C, Cherny N, Haugen DF. Use of opioid analgesics in the treatment of cancer pain: evidence-based recommendations from the EAPC. The lancet oncology. 2012; 13(2):e58-e68. doi: https://doi.org/10.1016/S1470-2045(12)70040-2

Ripamonti CI, Santini D, Maranzano E, Berti M, Roila F. ESMO Guidelines Working Group. Management of cancer pain: ESMO clinical practice guidelines. Annals of oncology. 2012; 23(7):vii139-vii154.doi: https://doi.org/10.1093/annonc/mds233

Roberto A, Greco MT, Legramandi L, Galli F, Galli M, Corli O. A comparison between the administration of oral prolonged-release oxycodone-naloxone and transdermal fentanyl in patients with moderate-to-severe cancer pain: a propensity score analysis. Journal of Pain Research. 2017: 10(1):2123. doi: 10.2147/JPR.S141928

Gretton SK, Ross JR, Rutter D, Sato H, Droney JM, Welsh KI, Riley J. Plasma morphine and metabolite concentrations are associated with clinical effects of morphine in cancer patients. Journal of pain and symptom management. 2013; 45(4):670-680. doi.org/10.1016/j.jpainsymman.2012.03.015

Siemens W & Becker G. Methylnaltrexone for opioid-induced constipation: review and meta-analyses for objective plus subjective efficacy and safety outcomes. Therapeutics and clinical risk management. 2016; 12(1):401. doi: 10.2147/TCRM.S80749

Davis M & Gamier P. New options in constipation management. Current oncology reports. 2015; 17(12):55. doi:10.1007/s11912-015-0481-x

World Health Organization. National cancer control programmes: policies and managerial guidelines. 2rd ed. Geneve: OMS. 2002. [Citado 2018 Out. 18]. Available from: http://www.who.int/cancer/media/en/408.pdf

Huang Y, Li X, Zhu T, Lin J, Tao G. Efficacy and safety of ropivacaine addition to intrathecal morphine for pain management in intractable cancer. Mediators of inflammation, 2015; 2015(ID 439014):6.doi: http://dx.doi.org/10.1155/2015/439014

Cherny N, Ripamonti C, Pereira J, Davis C, Fallon M, McQuay H. Expert Working Group of the European Association of Palliative Care Network. Strategies to manage the adverse effects of oral morphine: an evidence-based report. Journal of Clinical Oncology. 2001; 19(9):2542-2554.doi: 10.1200/JCO.2001.19.9.2542

Rentz AM, Yu R, Müller-Lissner S, Leyendecker P. Validation of the Bowel Function Index to detect clinically meaningful changes in opioid-induced constipation. Journal of medical economics. 2009; 12(4):371-383. doi: 10.3111/13696990903430481

Bader S, Dürk T, Becker G. Methylnaltrexone for the treatment of opioid-induced constipation. Expert review of gastroenterology & hepatology. 2013; 7(1):13-26. Doi: http://dx.doi.org/10.1586/egh.12.63

Jarmuż A, Banaszek M, Storr M, Fichna J. The Role of MOP and DOP Receptors in Treatment of Diarrheapredominant Irritable Bowel Syndrome. Mini reviews in medicinal chemistry. 2016; 16(18):1462-1469. doi:10.2174/1389557516666160804165318

Clark K, Currow DC. Constipation in palliative care: what do we use as definitions and outcome measures? Journal of pain and symptom management. 2013; 45(4):753-762. doi: https://doi.org/10.1016/j.jpainsymman.2012.03.016

Yeomanson D, Chohan O, Mayer A. Paediatric palliative care: intravenous methylnaltrexone relieves constipation. BMJ supportive & palliative care. 2012; 3(1):103–105. doi: http://dx.doi.org/10.1136/bmjspcare-2012-000291

Dhingra L, Shuk E, Grossman B, Strada A, Wald E, Portenoy A, Portenoy R. A qualitative study to explore psychological distress and illness burden associated with opioid-induced constipation in cancer patients with advanced disease. Palliative medicine. 2013; 27(5): 447-456.doi:10.1177/0269216312450358

Neefjes EC, Van der Vorst MJ, Boddaert MS, Zuurmond WW, Van der Vliet HJ, Beeker A, Verheul HM. Clinical evaluation of the efficacy of methylnaltrexone in resolving constipation induced by different opioid subtypes combined with laboratory analysis of immunomodulatory and antiangiogenic effects of methylnaltrexone. BMC palliative care. 2014; 13(1):42.doi: https://doi.org/10.1186/1472-684X-13-42

Nalamachu SR, Pergolizzi J, Taylor R, Slatkin NE, Barrett AC, Yu J, Forbes WP. Efficacy and Tolerability of Subcutaneous Methylnaltrexone in Patients with Advanced Illness and Opioid‐Induced Constipation: A Responder Analysis of 2 Randomized, Placebo‐Controlled Trials. Pain Practice. 2015; 15(6):564-571.doi: 10.1111/papr.12218

Taylor D, Radbruch L, Revnic J, Torres LM, Ellershaw JE, Perelman M.A report on the long-term use of fentanyl pectin nasal spray in patients with recurrent breakthrough pain. Journal of pain and symptom management. 2014; 47(6):1001-1007. doi:http://dx.doi.org/10.1016/j.jpainsymman.2013.07.012

Kurita GP, Lundström S, Sjøgren P, Ekholm O, Christrup L, Davies A, Dale O. Renal function and symptoms/adverse effects in opioid‐treated patients with cancer. Acta Anaesthesiologica Scandinavica. 2015; 59(8):1049-1059.doi: 10.1111/aas.12521

Higuchi T, Shimada K., Cho Y, Minami K., Takeuchi K., Sakamoto A. Effectiveness of subarachnoid drug infusion for pediatric tumor‐related pain. Pediatrics International. 2016; 58(8):760-763.doi: 10.1111/ped.12952

Fernández UB, Trevigno BA, Rodríguez ZN, Palma TC, Cid BL. Use of opioids in palliative care of children with advanced cancer. Revista chilena de pediatria. 2016; 87(2):96-101.doi: 10.1016/j.rchipe.2015.10.006

Nosek K, Leppert W, Nosek H, Wordliczek J, Onichimowski D. A comparison of oral controlled-release morphine and oxycodone with transdermal formulations of buprenorphine and fentanyl in the treatment of severe pain in cancer patients. Drug Design, Development and Therapy. 2017; 11(1):2409. doi: 10.2147/DDDT.S141007

Mazumdar A, Mishra S, Bhatnagar S, Gupta D. Intravenous morphine can avoid distressing constipation associated with oral morphine: a retrospective analysis of our experience in 11 patients in the palliative care in-patient unit. American Journal of Hospice and Palliative Medicine.2008; 25(4):282-284. doi: 10.1177/1049909108315913

Candy B, Jones L, Larkin PJ, Vickerstaff V, Tookman A, Stone P. Laxatives for the management of constipation in people receiving palliative care. The Cochrane Library.[Internet] 2015 [cited 2017 out. 22] Available from: 10.1002/14651858.CD003448.pub4

Wiffen PJ, Derry S, Moore RA. Impact of morphine, fentanyl, oxycodone or codeine on patient consciousness, appetite and thirst when used to treat cancer pain. Cochrane Database Syst Rev, 5. 2014; (4). doi: 10.1002/14651858.CD011056

Ercole FF, Melo LSD, Alcoforado CLGC. Revisão integrativa versus revisão sistemática. Revista Mineira de Enfermagem. 2014; 18(1):9-12.doi: http://www.dx.doi.org/10.5935/1415-2762.20140001