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Postoperative ileus — USMLE Step 3 MCQ

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HardSurgery (post-operative, follow-up)Postoperative ileusUSMLE Step 3

A colorectal enhanced-recovery pathway includes preoperative alvimopan. Which recent analgesic history meets the labeled contraindication?

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Correct answer: D — Therapeutic oxycodone taken daily for the eight consecutive days immediately before surgery

The best answer is “Therapeutic oxycodone taken daily for the eight consecutive days immediately before surgery”. Alvimopan is contraindicated after therapeutic opioid dosing for more than seven consecutive days immediately before treatment. Exactly seven days, nonconsecutive exposure, a single intraoperative dose, and nonopioid analgesia do not satisfy that precise labeled exclusion.

Reference: FDA Prescribing Information: ENTEREG: https://www.accessdata.fda.gov/drugsatfda_docs/label/2013/021775s010lbl.pdf