Opiates constipation with

Opiates Monitor patients for sedation and depressed cognition. Address constipation with use of stimulant laxatives. 

There are a number of side-effects of opiates that are due to their actions on opiate receptors outside the central nervous system. Opiates constrict the pupils by acting on the oculomotor nucleus and cause constipation by activating a maintained contraction of the smooth muscle of the gut which reduces motility. This diminished propulsion coupled with opiates reducing secretion in the gut underlie the anti-diarrhoeal effect. Opiates contract sphincters throughout the gastrointestinal tract. Although these effects are predominantly peripheral in origin there are central contributions as well. Morphine can also release histamine from mast cells and this can produce irritation and broncho-spasm in extreme cases. Opiates have minimal cardiovascular effects at therapeutic doses. 

All opiate derivatives are associated with constipation, but the degree of intestinal inhibitory effects seems to differ between agents. Orally administered opiates appear to have greater inhibitory effect than parenterally administered agents oral codeine is well known as a potent antimotility agent. 

Constipation may be caused by slow intestinal transition, pelvic floor dysfunction, bowel dysfunction like irritable Bowel syndrome and tumours, but can also be secondary to other diseases and life conditions. Many medicines cause constipation, for example opiates, calcium channel blockers and drugs with anticholinergic effects, e.g. antidepressants. 

Symptom patterns those with alternating constipation and diarrhoea and predominant constipation may benefit from high fibre diets (although excess fibre may bloat). Those with predominant diarrhoea may require simple peripheral opiate agonists (loperamide), but may also be helped by raised fibre intake. Pain may respond in part to explanation that it does not indicate serious illness and in part to spasmolytic therapy with anticholinergic agents which... 

Codeine, which is an opium alkaloid is most commonly opiate used as antitussive and more selective for cough centre. Like morphine, it depresses cough centre but is less constipating and abuse liability is low. It is relatively safe drug used in cough along with analgesic property and it s only important adverse effect is constipation. 

Constipation can be associated with the use of opiates, such as morphine and codeine, calcium channel blocking agents, antacids containing aluminium compounds and iron salts used in the treatment of anaemia. 

Analgesics. Opiates can precipitate hepatic encephalopathy in patients with decompensated liver disease. If required to control postoperative pain, doses should be reduced to 25-50% of normal. Constant intravenous infusions should be avoided if the patient is not to be insidiously overdosed. Codeine can precipitate hepatic encephalopathy by its constipating effect alone. Aspirin and other NSAIDs may exacerbate impaired renal function and fluid retention by inhibiting prostaglandin synthesis and may also precipitate gastrointestinal bleeding. 

Opiates Opiates decrease intestinal motility for 2 hours. Side effects of opiates are constipation and CNS depression when combined with tranquilizers, alcohol, and sedatives. Commonly prescribed opiates are ... 

Side effects of opiates are constipation and CNS depression when combined with tranquilizers, alcohol, and sedatives. 

Opioid antagonists (Table 7.4), predominantly naloxone, are used clinically to reverse the effects of opiates in overdose or postoperative sedation. Naltrexone, which has oral bioavailability, is used for the treatment of narcotic addiction and alcohol dependence. As discussed below (Section 2.2.2.1), peripherally selective antagonists are being evaluated for treatment of constipation and other gastrointestinal side effects associated with opioid agonist use. 

The constipating effect of orally administered opiates can be used for the treatment of diarrhea, as with camphorated tincture of opium (Paregoric or Parepectolin, which is a paragoric plus kaolin as an adsorbent and pec-... 

Emollient laxatives are ineffective in treating constipation, bnt are nsed mainly to prevent this condition. They may be helpfnl in sitnations in which straining at stool shonld be avoided, such as after recovery from myocardial infarction, with acnte perianal disease, or after rectal surgery. It is unlikely that these agents would be very effective in preventing constipation if major cansative factors (e.g., heavy opiate use, uncorrected pathology, or inadequate dietary fiber) are not concurrently addressed. 

Opiates decrease intestinal motility thereby decreasing persistalsis. Constipation is a common side effect. Examples are tincture of opium, paregoric (camphorated opium tincture), and codeine. Opiates are frequently combined with other antidiar-rheal agents and can cause central nervous system (CNS) depression when taken with alcohol, sedatives, or tranquillizers. Duration of action is about 2 hours. 

Codeine is associated with the same adverse events that may occur with an opiate. Respiratory depression, sedation, nausea, constipation, and pruritus are all common side effects of codeine. These effects are especially pronoimced in the elderly and may be more prolonged in any patient who is slow to clear the drug, such as patients with renal faUure. 

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