Objectives: Constipation caused by opioid-induced constipation (OIC) is prevalent among critically poisoned patients and can result in complications that prolong hospitalization and, in rare cases, cause bowel perforatio This research aimed to evaluate the safety and efficacy of lactulose and naloxone in the treatment of OIC in the intensive care unit for poisoning.
Materials And Methods: This was a randomized, double-blind, clinical trial of patients with opioid poisoning who experienced constipation for 14 months. Patients were divided into two groups: one receiving lactulose (30 cc daily) and the other receiving naloxone (8 mg three times a day). The parameters of age, gender, type of opioid used, Acute Physiology and Chronic Health Evaluation II score, Glasgow Coma Scale score, defecation time, and number of laboratory variables were recorded. All data were collected and analyzed using SPSS software.
Results: Of the participants in the lactulose group, 85.37% were male and 14.63% were female. In the naloxone group, 94.9% of patients were male and 5.1% were female. The average age of the lactulose group was 44 ± 16.2 and in the naloxone group was 48.13 ± 19.1 years. The average defecation time was 30.8 ± 23.1 hours in the naloxone group and 25 ± 11.5 hours in the lactulose group. Six patients (15%) in the naloxone group experienced treatment failure. Symptoms of withdrawal syndrome were experienced by 15 patients (39.5%) patients in the naloxone group.
Conclusion: The evidence suggests that lactulose is a superior treatment choice because it does not carry the risk of withdrawal syndrome or treatment ineffectiveness.
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http://dx.doi.org/10.4274/tjps.galenos.2024.80550 | DOI Listing |
Turk J Pharm Sci
January 2025
Shahid Beheshti University of Medical Sciences Faculty of Medicine, Toxicological Research Center, Excellence Center and Department of Clinical Toxicology, Tehran, Iran.
Objectives: Constipation caused by opioid-induced constipation (OIC) is prevalent among critically poisoned patients and can result in complications that prolong hospitalization and, in rare cases, cause bowel perforatio This research aimed to evaluate the safety and efficacy of lactulose and naloxone in the treatment of OIC in the intensive care unit for poisoning.
Materials And Methods: This was a randomized, double-blind, clinical trial of patients with opioid poisoning who experienced constipation for 14 months. Patients were divided into two groups: one receiving lactulose (30 cc daily) and the other receiving naloxone (8 mg three times a day).
Prehosp Emerg Care
January 2025
Department of Emergency Medicine, MetroHealth Medical Center, Cleveland, OH.
Objectives: Opioid-associated fatal and non-fatal overdose rates continue to rise. Prehospital overdose education and naloxone distribution (OEND) programs are attractive harm-reduction strategies, as patients who are not transported by EMS after receiving naloxone have limited access to other interventions. This narrative summary describes our experiences with prehospital implementation of evidence-based OEND practices across Ohio as part of the HEALing Communities Study (HCS).
View Article and Find Full Text PDFPrehosp Emerg Care
January 2025
Co-Principal Investigator, EMS Bridge, Alameda Health System - Highland Hospital, Emergency Medicine, 1141 E 31st. St, Oakland, CA, 94602.
Objectives: Opioids kill tens of thousands of patients each year. While only a fraction of people with opioid use disorder (OUD) have accessed treatment in the last year, 30% of people who died from an overdose had an Emergency Medical Services (EMS) encounter within a year of their death. Prehospital buprenorphine represents an important emerging OUD treatment, yet limited data describe barriers to this treatment.
View Article and Find Full Text PDFPrehosp Emerg Care
January 2025
National Registry of Emergency Medical Technicians, 6610 Busch Boulevard, Columbus, OH 43229, USA.
Objectives: Fatal and nonfatal pediatric opioid poisonings have increased in recent years. Emergency medical services (EMS) clinicians are often the first to respond to an opioid poisoning and administer opioid reversal therapy. Currently, the epidemiology of prehospital naloxone use among children and adolescents is incompletely characterized.
View Article and Find Full Text PDFAm J Emerg Med
December 2024
Icahn School of Medicine at Mount Sinai, Center for Research on Emerging Substances, Poisoning, Overdose, and New Discoveries (RESPOND), NYC Health + Hospitals/Elmhurst, New York, NY, USA.
Background: Tramadol is an adulterant of illicit opioids. As it is a serotonin-norepinephrine reuptake inhibitor as well as a μ-opioid agonist, tramadol adulteration may worsen overdose signs and symptoms or affect the amount of naloxone patients receive.
Methods: This is a multicenter, prospective cohort of adult patients with suspected opioid overdoses who presented to one of eight United States emergency departments and were included in the Toxicology Investigators Consortium's Fentalog Study.
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