Problem:
Client Scenario:
Diego is a 39-year-old male presenting with chronic constipation lasting two months. He reports his last bowel movement occurred four days ago and describes it as hard, pebble-like stool with straining and pain. Despite already trying both non-pharmacological interventions (increasing fluids) and first-line OTC pharmacologic agents (psyllium [bulk-forming], polyethylene glycol [osmotic], and magnesium oxide [saline laxative]), he has experienced no relief.
His past medical history includes hypertension and asthma, and his current medications are hydrochlorothiazide 25 mg PO daily and an albuterol inhaler PRN. He has an aspirin allergy. On exam, he is noted to have class III obesity (BMI 42) and blood pressure of 131/87, but his physical exam, including abdominal exam, is otherwise unremarkable. He is presenting today because his constipation has become chronic and refractory to first-line measures, requiring evaluation for second-line pharmacologic treatment options.
Discuss your personal professional assessment of the client's situation provided in the scenario. What pharmacological treatment is necessary and why? Need Assignment Help?