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Constipation medication — DGM MCQ

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ModerateContinenceConstipation medicationDGM

An 82-year-old woman has worsening constipation and dry mouth after a new tablet for neuropathic pain. She feels dizzy and has fallen once. Abdomen is soft and rectum contains hard stool. Current medicines include amitriptyline, paracetamol and macrogol. Which medication should be reviewed?

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Correct answer: E — Amitriptyline

Amitriptyline has anticholinergic effects causing constipation, dry mouth, dizziness and falls. Paracetamol, macrogol, colecalciferol and lansoprazole are less likely to explain the anticholinergic syndrome. Tricyclic antidepressants are often poorly tolerated in frail older adults.

Reference: BNF; STOPP/START criteria v3