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The impact of opiate pain medications and psychoactive drugs on the quality of colon preparation in outpatient colonoscopy.
- Source :
-
Digestive and liver disease : official journal of the Italian Society of Gastroenterology and the Italian Association for the Study of the Liver [Dig Liver Dis] 2014 Jan; Vol. 46 (1), pp. 56-61. Date of Electronic Publication: 2013 Sep 06. - Publication Year :
- 2014
-
Abstract
- Background: Suboptimal colon preparation is a significant barrier to quality colonoscopy. The impact of pharmacologic agents associated with gastrointestinal dysmotility on quality of colon preparation has not been well characterized.<br />Aims: Evaluate impact of opiate pain medication and psychoactive medications on colon preparation quality in outpatients undergoing colonoscopy.<br />Methods: Outpatients undergoing colonoscopy at a single medical centre during a 6-month period were retrospectively identified. Demographics, clinical characteristics and pharmacy records were extracted from electronic medical records. Colon preparation adequacy was evaluated using a validated composite colon preparation score.<br />Results: 2600 patients (57.3 ± 12.9 years, 57% female) met the inclusion and exclusion criteria. 223 (8.6%) patients were regularly using opioids, 92 antipsychotics, 83 tricyclic antidepressants and 421 non-tricyclic antidepressants. Opioid use was associated with inadequate colon preparation both with low dose (OR = 1.4, 95%CI 1.0-2.1, p = 0.05) and high dose opioid users (OR = 1.7, 95%CI 1.1-2.9, p = 0.039) in a dose dependent manner. Other significant predictors of inadequate colon preparation included use of tricyclics (OR = 1.9, 95%CI 1.1-3.0, p = 0.012), non-tricyclic antidepressants (OR = 1.5, 95%CI 1.1-2.0, p = 0.013), and antipsychotic medications (OR = 2.2, 95%CI 1.4-3.4, p = 0.001).<br />Conclusions: Opiate pain medication use independently predicts inadequate quality colon preparation in a dose dependent fashion; furthermore psychoactive medications have even more prominent effects and further potentiates the negative impact of opiates with concurrent use.<br /> (Copyright © 2013 Editrice Gastroenterologica Italiana S.r.l. All rights reserved.)
- Subjects :
- Adult
Aged
Ambulatory Care
Antidepressive Agents adverse effects
Dose-Response Relationship, Drug
Female
Humans
Male
Middle Aged
Retrospective Studies
Analgesics, Opioid adverse effects
Antidepressive Agents, Tricyclic adverse effects
Antipsychotic Agents adverse effects
Cathartics therapeutic use
Colonoscopy
Gastrointestinal Motility drug effects
Polyethylene Glycols therapeutic use
Subjects
Details
- Language :
- English
- ISSN :
- 1878-3562
- Volume :
- 46
- Issue :
- 1
- Database :
- MEDLINE
- Journal :
- Digestive and liver disease : official journal of the Italian Society of Gastroenterology and the Italian Association for the Study of the Liver
- Publication Type :
- Academic Journal
- Accession number :
- 24012559
- Full Text :
- https://doi.org/10.1016/j.dld.2013.07.020