Background: Affecting approximately 5.9% of the US population, alcohol use disorder (AUD) has been established as a prevalent disease in this country (1). Through repeated hospital admissions for alcohol use disorder (including alcohol withdrawal syndromes), hospital costs have steadily risen to recent estimates of 7.6 billion dollars in 2017 (2). Without the establishment of outpatient [...]

Background: Affecting approximately 5.9% of the US population, alcohol use disorder (AUD) has been established as a prevalent disease in this country (1). Through repeated hospital admissions for alcohol use disorder (including alcohol withdrawal syndromes), hospital costs have steadily risen to recent estimates of 7.6 billion dollars in 2017 (2). Without the establishment of outpatient [...]

Background: Methylnaltrexone (MNTX) is a peripherally acting µ-opioid receptor antagonist indicated for opioid-induced constipation (OIC), which can be a serious consequence of opioid analgesia. We evaluated whether baseline osmotic agent (eg, milk of magnesia, polyethylene glycol, lactulose, sorbitol) or stimulant (eg, senna, bisacodyl) use affects the efficacy and safety of MNTX among a subgroup of [...]

Background: It is estimated that 20% of patients who encounter the ED suffer from Alcohol Use Disorder (AUD) . Hospitalists encounter many Alcohol Withdrawal admissions and are often tasked with providing short counseling sessions on AUD due to time restraints. Furthermore, up to 50% of of patents admitted for Alcohol withdrawal will be readmitted for [...]

Background: Methylnaltrexone (MNTX) is a peripherally acting µ-opioid receptor antagonist indicated for opioid-induced constipation (OIC). We evaluated whether baseline use of laxatives, including stimulants, osmotic agents, stool softeners, or combinations thereof affects the efficacy and safety of MNTX. Methods: This post hoc analysis included pooled data from 2 multicenter, randomized, double-blind, placebo (PBO)-controlled, institutional review [...]

Background: Almost three-quarters of hospitals with 50 or more beds have a palliative care program, and the percentage of annual hospital admissions receiving an initial palliative care consultation is more than 5%. Methylnaltrexone (MNTX) is a peripherally acting µ-opioid receptor antagonist indicated for opioid-induced constipation (OIC) in patients with advanced illness who are receiving palliative [...]

Background: Subcutaneous (SC) methylnaltrexone (MNTX) is approved for opioid-induced constipation (OIC) in adults with chronic noncancer pain and OIC in adults with advanced illness or with active cancer who require opioid dosage escalation for palliative care. This post hoc analysis evaluated data pooled from 3 randomized studies of patients with advanced illness and OIC. Methods: [...]

Background: Opioid analgesia is an important treatment modality for patients with chronic pain, including pain attributed to cancer- and noncancer-related illness. Unfortunately, an estimated 40%–80% of opioid users experience opioid-induced constipation (OIC). Methylnaltrexone (MNTX) is indicated for the treatment of OIC. In clinical trials, the most common adverse events (AEs) were gastrointestinal (GI) in nature. [...]

Case Presentation: A 34-year-old female with a history of alcohol use disorder presented with severe withdrawal symptoms approximately one hour after receiving her first dose of naltrexone, which was prescribed for the management of alcohol cravings. The symptoms included excessive yawning, anxiety, irritability, tachycardia, generalized muscle cramps, and discomfort. Laboratory investigations revealed a blood alcohol [...]

Case Presentation: We present the case of a 58 -year-old opioid naïve man admitted for elective knee arthroplasty received parenteral hydromorphone and enteral oxycodone for analgesia. On post-operative day one, he developed abdominal pain. Abdominal X-ray showed stool burden suggesting constipation (OIC) prompting management with laxatives; he was given 12 mg parenteral methylnaltrexone. Overnight he [...]