Introduction: One of the most common undesired effects of analgesic opioid use and addiction is constipation. Numerous pharmacologic agents have been used to treat opioid-induced bowel hypomotility with limited success. Methylnaltrexone bromide (MNTX) selectively targets the peripheral adverse effects of opioids while preserving the central analgesic effects of opioid agonist treatment.
Case: While it is indicated for use in nonsurgical patients in the palliative care setting, here we report the use of MNTX for the alleviation of postoperative ileus in a heroin user with recurrent cervical cancer undergoing diverting colostomy and urinary conduit placement.
Conclusions: Results suggest that MNTX may accelerate postoperative gastrointestinal recovery in opioid-dependent patients. Further studies are warranted to evaluate its role in the pharmacologic management of postoperative ileus.
- Postoperative ileus
- Cervical cancer
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This study did not receive any financial support. Dr Jonathan Moss serves as a paid consultant to Progenics Pharmaceuticals, Inc, has a financial interest in methylnaltrexone bromide as a patent holder through the University of Chicago, and receives stock options from Progenics.