A 72-year-old man with chronic constipation is prescribed loperamide for symptomatic relief. He takes oxybutynin daily for overactive bladder. Vital signs show BP 138/82, HR 78, RR 16, temperature 37.2°C, SpO2 98%. Abdominal examination reveals decreased bowel sounds. Recent CT abdomen shows no obstruction. He denies abdominal pain. Which of the following represents the primary pharmacologic concern when combining these anticholinergic and opioid medications?
- A)Increased opioid absorption leading to systemic toxicity
- B)Excessive diarrhea from decreased parasympathetic tone
- C)Reduced efficacy of loperamide due to antagonistic effects
- D)Severe constipation and ileus from additive anticholinergic and opioid effectsGABARITO
- E)Enhanced serotonin syndrome from opioid-anticholinergic interaction
Explicação
Both loperamide and anticholinergic agents decrease intestinal motility through different mechanisms—opioids activate mu receptors on myenteric neurons, and anticholinergics block M3 receptors on smooth muscle. Combined use causes additive anticholinergic effe... Ver explicação completa e trilha adaptativa →