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Symptom Management Guidelines: CONSTIPATION

Symptom Management Guidelines: CONSTIPATION Definition(s) CONSTIPATION : A subjective experience of an unsatisfactory defecation characterized by infrequent stools and/or difficult stool passage ( straining, incomplete evacuation, hard/lumpy stools, prolonged time to pass stool, need for manual maneuvers) Contributing Factors Chemotherapy Agents Vinca alkaloids ( vincristine, vinblastine, vinorelbine) Platinums ( carboplatin, oxaliplatin) Taxanes ( paclitaxel) Thalidomide Medications Opioids Vitamin Supplements ( calcium and iron) Antiemetics ( 5-HT3 antagonists- ondansetron, granisetron) Drugs with anticholinergic effects ( antidepressants, antihistamines, antiparkinsonisms) Antispasmodics, anticonvulsants, phenothiazines Antacids that contain aluminum and calcium Diuretics Relevant Medical History Metabolic disturbances - Electrolyte imbalances ( hypercalemia, hyponatremia, hypokalemia) - Hypothyroidism - Uremia - Diabetes Neurological disturbances - Spinal cord involvement ( compression and injuries).

Constipation is a common side effect of all opioids. The constipating effects are not dose dependent and tolerance to the constipating effects does not occur Opioids cause decreased motility by suppression of intestinal peristalsis and increased water and electrolyte re– ...

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