1.Which of the following patients is at risk of opioid-induced constipation

A 32-year-old initiating hydrocodone therapy for low back pain

A 64-year-old who is receiving long-term oxycodone treatment for cancer pain

A 57-year-old who is initiating methadone therapy for severe osteoarthritis pain

All of the above

2.Opioids exert their effect on the gastrointestinal tract through:

Gamma-opioid receptor

Mu-opioid receptor

Opioid-binding protein

Diminished dopamine production

3.Which of the following laxatives is considered a surfactant laxative/stool softener?

Psyllium

Senna

Docusate

Magnesium sulfate

4.Which of the following OIC treatments can have reduced effectiveness in patients receiving methadone?

Methylnaltrexone

Naloxegol

Lubiprostone

Naldemedine

5.A 57-year-old woman has been prescribed methadone every 12 hours as well as oxycodone PRN to alleviate pain due to rheumatoid arthritis. After 2 weeks, she complains of infrequent stools that are difficult to pass and is prescribed senna along with a recommendation to increase her dietary fiber intake. After 2 weeks, she reports no improvement in bowel movements and complains that she spends an excessive amount of time on the toilet. An appropriate next step for this patient is:

Increase the dose of senna

Add a bulking agent (e.g., psyllium) to her regimen

Initiate treatment with a PAMORA.

Initiate treatment with lubiprostone.