13th November 2020

A frail gentleman with known colorectal cancer is admitted extremely confused and agitated

A frail gentleman with known colorectal cancer is admitted extremely confused and agitated, complaining of severe abdominal pain, nausea and vomiting. On examination, his abdomen is distended. His wife reports he has been unable to open his bowels for several days. An abdominal x-ray is performed, which shows dilated loops of large bowel. He is not suitable for surgical intervention and does not tolerate repeated attempts to insert a nasogastric tube. His regular medications are de-prescribed, suitable pain relief and anti-emetics are all prescribed subcutaneously. 

Please select the SINGLE most appropriate drug to use to manage the patient’s abdominal symptoms. Select ONE option from the list above.