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: Despite its prevalence, constipation is frequently under-recognized and treated with ineffective agents in hospitalized older adults. Methods: An anonymous survey was distributed to physicians regarding constipation management in hospitalized older adults. Chi-square or Fisher’s exact, as appropriate, were used to explore associations between demographics and survey answers. T-test was used to compare groups on [...]

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: Constipation is a common pediatric complaint and cause of abdominal pain in the pediatric age group. Management for constipation is generally completed in the outpatient setting, but many patients may require inpatient management after failure of outpatient therapy. Methods: We utilized data from the 2012 Kids’ Inpatient Database (KID), a nationally representative sample of [...]

Background: Constipation is commonly encountered in patients admitted to the hospital, with a variety of possible treatments to choose from. Docusate is often prescribed to treat constipation, though evidence suggests it is ineffective. Utilizing an ineffective medication adds to patients’ pill burden, health care costs, and may delay the use of effective medications with downstream [...]

Case Presentation: 21 month old male presents to the hospital for constipation that failed outpatient therapy. Parents describe one hard difficult to pass bowel movement (BM) every other day, without pencil thin stools, blood or mucus. Constipation began at 3 months of age when they introduced formula. He passed meconium within the 24 hours of [...]

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: [...]

Case Presentation: A 70-year-old male with a history of type 2 diabetes mellitus complicated by neurogenic bladder with indwelling catheter and severe peripheral vascular disease status post bilateral below knee amputations (BKAs) presented with watery diarrhea and nausea for 1 day. Both amputations were in the preceding four months. He required multiple rounds of antibiotics [...]

Case Presentation: A 78-year-old man with heart failure, chronic kidney disease, and hereditary spastic paralysis was hospitalized with hyperkalemia to 7.7 mmol/L. He was admitted a month prior with heart failure and discharged on lisinopril with a new prescription for spironolactone. The patient had decreased appetite, limited oral intake, mild nausea, and no vomiting with [...]