Which side effect is common with opioids and how to prevent?

• A. Nausea; treat with antiemetics
• B. Drowsiness; monitor
• C. Constipation; prevent with stool softeners or laxatives
• D. Headache; manage with analgesics

Answer: (C)

Constipation is a frequent side effect of opioid therapy. Opioids bind to mu receptors in the gut and slow intestinal motility, which leads to more water being absorbed from stool and harder, less frequent bowel movements. Because this effect tends to persist with ongoing opioid use, preventing it from the start is important. Start a bowel regimen when beginning opioids: use a stool softener to keep stool pliable and add a laxative to promote regular stools (options include stimulant laxatives or osmotic laxatives). Also encourage adequate hydration and activity. If constipation is still a problem despite these measures, consider additional strategies that target the gut, such as specialized medications that block opioid receptors in the gut while preserving pain relief.