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학습 자료 둘러보기 →Unlike nausea or sedation, tolerance to opioid-induced constipation (OIC) does not develop. Opioids bind to mu-receptors in the gut, slowing peristalsis and increasing fluid absorption. A preventive bowel regimen must be started with the first dose.
The regimen typically combines a stimulant laxative (e.g., senna) to promote motility and an osmotic laxative (e.g., polyethylene glycol) to retain fluid in the bowel. Increasing dietary fiber and fluid intake to 1.5-2 L/day is supportive but not sufficient alone.
Do not rely on PRN laxatives. Assess bowel function daily, including frequency and consistency. In geriatric patients, untreated constipation can lead to fecal impaction, overflow incontinence, or even bowel obstruction.
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