Mrs. M is an 87-year-old female residing in a skilled nursing facility. Her medication list includes: Apixaban 5 mg BID (for atrial fibrillation) Docusate 100 mg BID Senna 8.6 mg BID PEG 17 g daily Calcium carbonate 500 mg TID Lisinopril 10 mg daily Metoprolol...
I think I’ve seen this scenario play out more times than I would like. A patient is prescribed both a laxative, Senna, and Questran (cholestyramine), a medication used to manage diarrhea symptoms. This example of the prescribing cascade often presents slowly...
JE is a 77-year-old male. He reports significant constipation despite the use of three laxative medications. In this case summary, I will outline the most important medications that can contribute to constipation polypharmacy. Past medical history includes:...
In the case below, I discuss constipation management and how to reduce polypharmacy by targeting medications that cause this adverse effect. KE is a 77-year-old male with a history of GERD, pruritis, insomnia, low back pain, and recent knee replacement. Constipation...
At its worst, constipation can be a very serious issue in some patients and at best be a significant nuisance. Here’s a classic example of the constipation prescribing cascade. A 72-year-old female has a history of chronic pain, urinary incontinence,...
