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Opioid-induced constipation — GPhC CRA MCQ

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ModerateCNS TherapeuticsOpioid-induced constipationGPhC CRA

A 66-year-old man has started morphine modified-release tablets for cancer pain. He says the pain is better but he has not opened his bowels for three days. He takes senna occasionally. What is the most appropriate action?

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Correct answer: B — Recommend regular stimulant laxative with an osmotic laxative if needed

Opioid-induced constipation is common and tolerance does not reliably develop. Regular laxatives are usually prescribed when regular opioids are started, often a stimulant with or without an osmotic agent. Bulk-forming laxatives may be unsuitable if fluid intake is poor or bowel motility is reduced.

Reference: BNF; NICE CKS