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Opioid-induced constipation — GPhC CRA MCQ

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EasyGastro-intestinal TherapeuticsOpioid-induced constipationGPhC CRA

A 70-year-old woman taking oxycodone modified-release for severe osteoarthritis pain has not opened her bowels for 4 days. She has no vomiting or abdominal distension. She asks for a suitable OTC option and is already drinking adequate fluid. What is the most appropriate alternative?

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Correct answer: A — Senna tablets at night with review if symptoms persist

Opioids commonly cause constipation and a stimulant laxative such as senna is a reasonable choice if no red flags are present. Ongoing review is needed because opioid constipation can persist. Loperamide and kaolin are antidiarrhoeals and would worsen constipation. Bulk-forming laxatives require careful fluid intake and may not be ideal in opioid-induced constipation.

Reference: BNF; NICE CKS Constipation