Morphine
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Constipation treated with methylnaltrexone bromide: case report A 49-year-old man with severe diabetic neuropathy developed worsening constipation during treatment with morphine for neuropathic pain; constipation was successfully treated with methylnaltrexone bromide. The man, with a 12-year history of severe insulin resistant type 2 diabetes mellitus, was receiving 1g morphine equivalent per day [route of administration not stated] and lidocaine plasters for pain control. Severe constipation causing abdominal distension, nausea and anorexia, subsequently developed [time to reaction onset not stated]. Treatment with aperients and laxatives was ineffective, only producing flatus. He was only able to pass hard pelleted stool after painful straining once a month and his poor QOL led to discussions about assisted suicide. The man’s current treatment regimen included a highfibre diet and fluids, high dose laxatives, intermittent erythromycin and rectal interventions. He then received SC methylnaltrexone bromide 8mg and defecation occurred 1 hours later. After one month, his QOL had improved and he was able enjoy meals without nausea and bloating. Cardoso A, et al. Methylnaltrexone to relieve opioid induced constipation in severe diabetic neuropathy. Practical Diabetes International 27: 149, No. 4, May 2010. 803028365 Available from: URL: http://dx.doi.org/10.1002/pdi.1470 - Portugal
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Reactions 7 Aug 2010 No. 1313
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