Date of Graduation

8-15-2009

Degree Type

Capstone Project

Degree Name

Master of Science in Physician Assistant Studies

First Advisor

Rob Rosenow PharmD, OD

Second Advisor

Annjanette Sommers MS, PAC

Abstract

Background: Opioid-induced constipation (OIC) is a major problem that can have a significant impact on a patient’s quality of life (QoL). The use of opioids for both long and short term analgesia has been the standard treatment for many years. All opioids, like oxycodone, can be connected with the development of bowel dysfunction, with constipation being one of the more frequently reported adverse effects. Many of the standard methods and protocols that hospitals use seem to have little effect on this continuing problem.

Hypothesis: That the use of oral naloxone Prolonged Release (PR), in conjunction with oxycodone PR, will improve patient bowel function, without effecting analgesia or creating additional side effects that decrease patients’ QoL.

Study Design: Exhaustive search of available medical literature.

Methods: The intent of this study was to seek out and review the most current literature available on this problem utilizing a minimum of three search engines. The review of literature was limited to Randomized Control Trials (RCT) published since 2008.

Results: five studies were found that met the criteria for inclusion in this review. Two of the five were based upon the same data although with separate clinical questions.

Conclusion: The studies showed that naloxone PR, when given to a patient who is established on a stable dose of oxycodone PR, significantly improved the patients’ bowel function, without adding additional adverse events, causing opioid withdrawal or decreasing analgesic properties, and that the optimum ratio which produced the leased number of adverse events was 2:1.

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