Episode Chapters
- Interstitial Cystitis14:54Sepsis18:56Paper Chase #1 - Zoliflodacin for Gonorrhea7:37Nephrotic Syndrome in Kids15:51Pharmacologic Treatment of Alcohol Use DisorderFree Chapter16:31Paper Chase #2 - COMPASS Trial6:22Aspirin: The Latest Literature10:27Alcohol Use Disorder: Emerging Therapies9:10Paper Chase #3 - AGA Guideline on Opioid-Induced Constipation5:32Balanoposthitis19:04Management of Borderline Personality Disorder18:44Paper Chase #4 - Kidney Damage Biomarkers and CKD in BP Reduction4:57Acute Rhinosinusitis11:48Feedback in Education13:54Paper Chase #5 - Complications of Indwelling Urethral Catheters6:39Summary8:47
To present official recommendations for the medical management of opioid-induced constipation.
A World of (Bladder) Hurt Full episode audio for MD edition 186:36 min - 88 MB - M4AHippo Primary Care RAP - March 2019 Written Summary 1 MB - PDF
Chris - March 17, 2019 9:44 AM
Interesting to hear about the PAMORAs, but I was a struck by the passing mention of docusate at the end as a "standard go to." Though it does still seem to get a lot of use in clinical practice, my understanding was that docusate has questionable efficacy as a laxative. From the CADTH review:
"Docusate does not increase stool frequency or soften stools compared with placebo.
Docusate does not improve the symptoms of constipation.
Docusate does not improve the difficulties or completeness of stool evacuation in patients taking opioids."
(https://www.cadth.ca/dioctyl-sulfosuccinate-or-docusate-calcium-or-sodium-prevention-or-management-constipation-review)
Neda F., MD - March 19, 2019 9:33 AM
Hi Chris! We were just having this same conversation on the PC RAP team about docusate. We'll be covering this review in the future.