PUJI LISTIANA RAHAYU, 051511133171 (2019) PENGARUH BISAKODIL TERHADAP EKSPRESI TRANSPORTER AQUAPORIN-3, AQUAPORIN-4 DAN PPARγ PADA KONSTIPASI YANG DIINDUKSI MORFIN. Skripsi thesis, Universitas Airlangga.

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Abstract

Morphine is an opioid analgesic used to treat acute pain and chronic pain. Morphine can cause constipation due to the effect on the enteric nervous system and increased level of aquaporin transporter expression in colon. The administration of morphine is known by activation of PPARγ through increasing serotonin release. Activation of PPARγ causes an increase in aquaporin expression. Increased on the level of aquaporin expressions can cause constipation because the transport of a large amount of water from luminal side to vascular side. Bisacodyl is a laxative stimulant that has been recommendend as first line therapy to treat Opioid-Induced Constipation (OIC). The mechanism of bisacodyl increased smooth muscle contraction, decreased absoption fluid and electrolyte in the gastrointestinal tract and reduced the level of aquaporin-3 and aquaporin-4 water transporter. The aim of this study was to analyze the mechanism of bisacodyl on water transponter in the large intestine by observing fecal water content, colonic bead expulsion and the level of aquaporin-3, aquaporin-4 and PPARγ expressions in morphine-induced constipation. The results of the study showed significant differences in the faecal water content on the seventh day between the bisacodyl-morphine group (p<0,0001) and the saline-morphine group (p<0.01). The bead colonic expulsion assessment showed a decreased in bead evacuation time, but this decrease was not statistically different. In the assessment of aquaporin-3, aquaporin-4 and PPARγ expression did not show significant differences (p>0,05). This was due to the time gap between the last morphine/bisacodyl administraton and sampling time. Based on the description above, it can be concluded that bisacodyl is able to overcome morphine-induced constipation, but the mechanism of bisacodyl through water transporters has not been known.

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