Developments in managing severe @entity1118 : role of XXXX - @entity1510 extended release.

@entity1 @entity1288 @entity5 @entity4784 @entity1510 @entity158 @entity1443 @entity1118
@entity1118 is a highly disabling condition, which can significantly reduce @entity1 ' quality of life. Prevalence of moderate and severe @entity1118 is high in the general population, and it increases significantly in @entity1 with advanced @entity5 and older than 65 years. Guidelines for the management of @entity1118 recommend opioids for the treatment of moderate-to-severe @entity158 in @entity1 whose @entity158 is not responsive to initial therapies with @entity1443 and/or nonsteroidal anti-inflammatory drugs. Despite their analgesic efficacy being well recognized, adverse events can affect daily functioning and @entity1 quality of life. @entity4784 ( @entity4784 ) occurs in 40% of opioid-treated @entity1 . Laxatives are the most common drugs used to prevent and treat @entity4784 . Laxatives do not address the underlying mechanisms of @entity4784 ; for this reason, they are not really effective in @entity4784 treatment. @entity1510 is an opioid receptor antagonist with low systemic bioavailability. When administered orally, @entity1510 antagonizes the opioid receptors in the gut wall, while its extensive first-pass hepatic metabolism ensures the lack of antagonist influence on the central-mediated analgesic effect of the opioids. A prolonged-release formulation consisting of @entity1288 and @entity1510 in a 2:1 ratio was developed trying to reduce the incidence of @entity4784 maintaining the analgesic effect compared with use of the sole @entity1288 . This review includes evidence related to use of @entity1288 and @entity1510 in the long-term management of chronic non- @entity5 @entity158 and @entity4784 .
