C.J. is a 71-year-old woman who presents for follow-up. She complains of hard, dry stools

C.J. is a 71-year-old woman who presents for follow-up. She complains of hard, dry stools over the past week. She remembers reading an educational brochure she picked up in her pharmacy that suggested increasing her fiber and fluid intake, but this has not alleviated her problem. C.J.’s past medical conditions include hypertension and chronic renal insufficiency. She had a stroke 1 year ago with little or no residual. Her medications include verapamil SR 240 mg daily, lisinopril 10 mg orally once daily, calcium carbonate 1,250 mg twice daily orally, and aspirin 325 mg orally once daily. You diagnosed her with constipation. 1. List specific goals of treatment for this patient. 2. What drug therapy would you prescribe? Why? 3. What are the parameters for monitoring the success of the therapy? 4. Discuss specific patient education based on the prescribed therapy. 5. List one or two adverse reactions for the selected agent that would cause you to change therapy. 6. What would be the choice for second-line therapy? 7. What over-the-counter or alternative medications would be appropriate for this patient? 8. What dietary and lifestyle changes should be recommended for this patient? 9. Describe one or two drug-drug or drug-food interactions for this patient.

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