Rapid responses are electronic comments to the editor. They enable our users
to debate issues raised in articles published on bmj.com. A rapid response
is first posted online. If you need the URL (web address) of an individual
response, simply click on the response headline and copy the URL from the
browser window. A proportion of responses will, after editing, be published
online and in the print journal as letters, which are indexed in PubMed.
Rapid responses are not indexed in PubMed and they are not journal articles.
The BMJ reserves the right to remove responses which are being
wilfully misrepresented as published articles or when it is brought to our
attention that a response spreads misinformation.
From March 2022, the word limit for rapid responses will be 600 words not
including references and author details. We will no longer post responses
that exceed this limit.
The word limit for letters selected from posted responses remains 300 words.
As mentioned in the article morphine and other opiod derivatives form
the mainstay of the treatment but they have their own side effects like
constipation, nausea and drowsiness being most important.
Every patient on opiods should be on a laxative, in patients with
poor responses to conventional laxatives co-danthramer is one of the best
options. We should never forget the role of fluids, fresh fruits and
vegetables that benefit in releiving constipation but also help in
building up the patient's health.
In terms of use of anti-emetic, pain is one of the reasons for nausea
hence this should be well controlled. We can use ondansetron preferably
while the patients are on chemotherapy or just after. During other periods
cyclizine or metoclopramide is a good replacement.But be aware of the fact
that the above two do antagonize the effects of each other. we can use a
regular anti-emetic if nausea is very troublesome like in the form of
domperidone and use of cyclizine as and when required.
Side effects while using opiods and their management
As mentioned in the article morphine and other opiod derivatives form
the mainstay of the treatment but they have their own side effects like
constipation, nausea and drowsiness being most important.
Every patient on opiods should be on a laxative, in patients with
poor responses to conventional laxatives co-danthramer is one of the best
options. We should never forget the role of fluids, fresh fruits and
vegetables that benefit in releiving constipation but also help in
building up the patient's health.
In terms of use of anti-emetic, pain is one of the reasons for nausea
hence this should be well controlled. We can use ondansetron preferably
while the patients are on chemotherapy or just after. During other periods
cyclizine or metoclopramide is a good replacement.But be aware of the fact
that the above two do antagonize the effects of each other. we can use a
regular anti-emetic if nausea is very troublesome like in the form of
domperidone and use of cyclizine as and when required.
regards
Dr Prabhu S U
Competing interests:
None declared
Competing interests: No competing interests