COMAT Emergency Medicine Practice Test

In the management of opioid-induced constipation, loperamide is contraindicated because it is an opioid agonist that can potentially worsen constipation. Loperamide works by slowing down intestinal motility, which is not desirable in patients who are already experiencing constipation due to opioid use. Instead of providing relief, loperamide would further decrease bowel movement frequency and exacerbate the issue.

In contrast, treatments such as polyethylene glycol, bisacodyl, and senna are appropriate options for addressing opioid-induced constipation. Polyethylene glycol is an osmotic laxative that helps draw water into the intestines, softening stool and promoting bowel movements. Bisacodyl is a stimulant laxative that directly stimulates motility in the intestine, helping to alleviate constipation effectively. Senna, another stimulant laxative, works similarly by stimulating bowel contractions. Thus, these options appropriately counteract the effects of opioids on bowel function, making them suitable for treating opioid-induced constipation.