Medications That May Be Useful in the Management of Patients with Chronic Intractable Pain
Michael S. Margoles, Richard Weiner in Chronic PAIN, 2019
Constipation can be a factor in the pain syndrome itself or can be a side effect of medication. Medications known to produce constipation are the TCAs (amitriptyline, desipramine, etc.) and some of the opioid and opioid-containing analgesics. The general approach to this problem is easily remedied by putting more fiber in the diet (fruits and vegetables). For some, this has no effect. In a number of cases, gentle laxatives such as Senokot® and Senokot S® (a natural plant laxative) can be of value. In some of the more resistant cases, milk of magnesia taken regularly throughout the day can be of value. With some of the stronger analgesics, such as methadone and morphine, constipation can be a serious problem. A combination of Senokot® and milk of magnesia may be of better benefit here. Small doses of each can be taken throughout the day. For the more problematic constipation, herb teas may be of great value. One is “Dieters’ Green Tea” and the other is “Super Slimming Tea.” Both of the teas can be purchased in Japanese markets and health food stores. Lactulose can be of great benefit in the last cases mentioned.
Constipation
Margaret O’Connor, Sanchia Aranda, Susie Wilkinson in Palliative Care Nursing, 2018
It is important that nurses understand the action time of laxatives commonly used in palliative care. Some examples are: a stimulant laxative such as dantron (co-danthramer standard preparation) as 2 capsules or 10mls suspension at night takes 6–12 hours for onset; Note: use is restricted to terminally-ill patients and there is a risk for skin irritation and excoriation if stool is in prolonged contact (as in incontinent patients);a stimulant laxative such as senna (Senokot) in 7.5 mg tablets or 5.5 mg granules or 10–20 mls at night takes 6–12 hours for onset;osmotic laxatives such as macrogols (Movicol 2–3 sachets daily, 4–8 hours for onset).
Spinal cord injuries and fractures
Michael Y. Wang, Andrea L. Strayer, Odette A. Harris, Cathy M. Rosenberg, Praveen V. Mummaneni in Handbook of Neurosurgery, Neurology, and Spinal Medicine for Nurses and Advanced Practice Health Professionals, 2017
Bowel dysfunction is devastating in patients with SCI because it does not only affect skin integrity but also quality of life. Patients can develop many gastrointestinal complications, such as ileus, ulcers, reflux, autonomic dysreflexia, constipation, distention, and so on. It is important to establish a bowel regimen early on in the injury. These regimens normally include a stool softener three times a day, a gentle laxative (such as Senokot), and an enema once a day. The patient can administer these medications whenever he or she desires. Some individuals like to do it at the start of their day, and others before bedtime. In addition, a patient should have a nutritious, high-residue diet, with plenty of fluids.
Quercetin promotes gastrointestinal motility and mucin secretion in loperamide-induced constipation of SD rats through regulation of the mAChRs downstream signal
Published in Pharmaceutical Biology, 2018
Ji Eun Kim, Mi Rim Lee, Jin Ju Park, Jun Young Choi, Bo Ram Song, Hong Joo Son, Young Whan Choi, Kyung Mi Kim, Jin Tae Hong, Dae Youn Hwang
Constipation is well known as an acute or chronic gastrointestinal disease characterized by infrequent bowel movements, hard and dry faeces, incomplete bowel evacuation and difficulty during defecation (Walia et al. 2009). Until now, several drugs were developed to treat this disease. In most cases, chemical drugs (laxatives) including Senna™, Correctol®, Exlax®, Senokot™ and Gaviscon® act as stimulants to increase bulkiness and soften stool or as osmotic agents, trigger bowel movements and enhance water flow into the colon to promote elimination (Voderholzer et al. 1997). But, most of above drugs showed some undesirable side effects, such as myocardial infarction, artery contraction and coronary spasms (Lembo and Camilleri 2003; Busti et al. 2004; Kim et al. 2013). Therefore, many studies have focused on identifying novel laxatives with no side effects to treat constipation patients. As part of above studies, we investigated the laxative effect and action mechanism of QCT in Lop-induced constipation model. The results of the present study first demonstrated that QCT can improve the symptoms of constipation through the elevation of stool excretion, and the recovery of histological changes of the transverse colon in Lop-induced constipation model. Especially, our data show the laxative effects of QCT are tightly correlated with the interaction between QCT and mAChR M2/3 signalling pathway.
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