Aubre R. presents as a new patient to your practice having recently relocated from rural Tennessee. She is 68 years old and complains of irritable bowel syndrome (IBS) with abdominal cramping and frequent diarrhea with occasional constipation. She has a history of domestic violence with resultant anxiety requiring inpatient hospitalization 8 years ago. She is also complaining of urinary retention, insomnia, and hip pain since a hip fracture 4 years ago. Her drugs include zolpidem 10 mg hs, bethanechol 25 mg tid, metoclopramide 10 mg tid, amitriptyline 100 mg hs, alprazolam 0.25 mg tid, hydrocodone/APAP 5/500 tid, and dicyclomine 20 mg four times daily.
1. What are your concerns about this drug regimen?
2. What recommendations do you have for this patient?
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