Which medication is prescribed alongside chronic opioid analgesic therapy specifically to prevent opioid-induced constipation, an adverse effect to which patients do not develop tolerance?

Answer and explanation

Correct answer: C. Stimulant laxative (e.g., Senna) combined with a stool softener

  1. Step 1: Opioids bind to intestinal -opioid receptors, depressing peristalsis and reducing intestinal secretions. Patients develop tolerance to sedation and analgesia, but never to constipation.
  2. Step 2: Prophylactic co-prescription of a stimulant laxative (such as senna or bisacodyl) with a stool softener (docusate) or osmotic agent (polyethylene glycol) is standard clinical practice to maintain regular bowel function.
Answer
Stimulant laxative (e.g., Senna) combined with a stool softener.
Why not the others: Diphenoxylate-atropine and loperamide are anti-diarrheal agents that worsen constipation; bismuth subsalicylate treats traveler's diarrhea and gastritis.

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