Abstract
Opioids are still the mainstay in the treatment of many types of severe chronic pain status. But opioids treatment is associated with a variety of bothersome side effects.
Among possible adverse events, opioid-induced constipation (OIC) is some of the most common and may persist as long as the patient is taking opioid therapy. OIC is mediated by activation of opioid receptors that are located in enteric nervous system in the gut by exogenous opioids.
OIC may be often very devastating for patient and it is associated with reduced work productivity, a decrease in quality of life and may lead to rejection of opioid use. Many predictive arrangements and use of conventional laxatives are recommended as basic approaches to OIC, but results may be inadequate in many patients.
As a result, there are developed pharmacological treatment that are more suited for OIC treatment in adult patients with chronic pain. Peripherally acting μ-opioid receptor antagonists (PAMORAs) directly affect the pathophysiologic mechanism of OIC.
One of new type of PAMORAs - naloxegol has become available also in the Czech Republic. It has been shown to be safe and effective in the OIC treatment on the basis of our short experience results.