Medication-induced constipation Quiz: Ace Your Exams
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A 68-year-old woman is seen in the primary care clinic due to persistent constipation. The patient has severe lumbar spinal stenosis and has taken oxycodone 10 mg every four hours for the past month. The dose has been titrated up over time, and the patient feels relief of pain at the current dose. The patient otherwise has no medical history and takes no other medications. The patient’s last bowel movement was six days ago and bowel movements have been very firm and difficult to pass. On physical examination, the patient has abdominal distension in both lower quadrants with minimal left lower quadrant tenderness to palpation. Counseling on fluid intake, increased physical activity, and a high-fiber diet is provided. The patient is started on a combination of senna and polyethylene glycol without resolution of symptoms. Which of the following medications should be given at this time?
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