PATIENT MISTAKES

Dr Helen Cowan, a qualified nurse with a PhD in cardiac pharmacology, describes some of the mistakes she’s come across. This week: Getting constipated on codeine I’VE COME across countless patients who become constipated when taking the painkiller codeine, a strong, potentially addictive opioid from the same family of drugs as morphine.

Patients assume because they have never had bowel problems in the past that they don’t need to take the laxative ( such as lactulose) which is generally prescribed alongside it. Codeine is an effective painkiller, but it reduces the muscular contractions that move food and faecal matter through the gut and the patient will often become constipated. In rare cases, taking codeine for more than a few weeks can cause impaction where the faecal matter builds up in the bowel and it can be gruesome to have to treat.