Printed Guideline for Management and Prevention of Opioid Related Constipation

Printed guideline for management and prevention of

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Printed
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Guideline for Management and Prevention of Opioid Related Constipation Staff Health and Safety Appropriate equipment (gloves/aprons etc) should be worn when in contact with faecal material or when administering rectal preparations of aperients In event of uncertainty, consultation should be had with MDHB Infection Control services Document No: MDHB-7120 Page 2 of 7 Version: 1 /var/filecabinet/temp/converter_assets/9d/10/9d1028f32e6c5d80f281c0cd4707b89005ac57ec.doc Printed
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Guideline for Management and Prevention of Opioid Related Constipation Document No: MDHB-7120 Page 3 of 7 Version: 1 /var/filecabinet/temp/converter_assets/9d/10/9d1028f32e6c5d80f281c0cd4707b89005ac57ec.doc Printed
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Guideline for Management and Prevention of Opioid Related Constipation 5. DEFINITION CCB Calcium channel blocker TCA Tricyclic antidepressant BD Twice a day (Latin: bis die ) TDS Three times a day (Latin: ter die sumendum ) PRN As and when necessary (Latin: pro re nata ) PR Rectal examination STAT Give at once or immediately (Latin: statim ) 6. RELATED MDHB DOCUMENTS MDHB-4184 Pain, Acute: Pharmacological Management in Adults 7. FURTHER INFORMATION / ASSISTANCE Clinical Pharmacist Opioid Collaborative Group 8. APPENDICES APPENDIX 1 Monitoring and laxative information 9. KEYWORDS Constipation, opioid Document No: MDHB-7120 Page 4 of 7 Version: 1 /var/filecabinet/temp/converter_assets/9d/10/9d1028f32e6c5d80f281c0cd4707b89005ac57ec.doc Printed
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Guideline for Management and Prevention of Opioid Related Constipation APPENDIX 1 Monitoring All nursing staff should monitor, record and review patient’s bowel status during every shift and notify the medical practitioner overseeing the patient’s care if loose stools are observed or if a new step in the flow-diagram needs to be initiated. If a patient declines any treatments indicated in the guideline, nursing staff should notify practitioners overseeing the patient’s care. Medical practitioners should review the patient and consider appropriate alternative treatment options. It is expected that nursing staff and medical practitioner addresses patient concerns and provides information about the treatment as stipulated by the Code of Rights. All practitioners should monitor and review patient’s bowel status daily, and stop laxatives when appropriate. Oral Laxatives Bulk-forming laxatives such as psyllium husk or sterculia are not recommended for patients with opioid-induced constipation due to an increased risk of bowel obstruction, especially in patients that are immobile or have poor fluid intake. However these agents are considered first-line for general constipation alongside non-pharmacological measures. It may take 72 hours before laxative effect is seen.
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