Pharmacologic treatment of constipation in cancer patients.

Abstract

10 Cancer Control spinal cord compression, and electrolyte abnormalities such as hypercalcemia or hypokalemia) to iatrogenic pharmacologic treatment) in nature.5 Patients with cancer, especially those with advanced cancer, often have multiple factors at play, such as opioid analgesic use, reduced food and fluid intake, reduced mobility, advanced age, or malignancy-related conditions (eg, partial bowel obstruction, tumor-related hypercalcemia, and chemotherapyinduced constipation).6 Constipated cancer patients may have poor performance status, which implies decreased mobility,as well as poor nutritional status,and they may be taking medications that contribute to constipation. Besides opioids, which comprise the most common class to induce constipation, many drug classes may result in constipation including chemotherapy agents, anticholinergics (tricyclic antidepressants,phenothiazines), calcium or aluminum-containing antacids, iron preparations, and antiemetics (5-HT3 antagonists) (Table 1). Constipation is probably the most prevalent side effect of opioid use, and it is also the side effect that is least likely for tolerance to develop.3 Thus, prophylactic laxatives should be used when administering such agents on a regular basis.2 Introduction