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Prednisolone gastroprotection risk — GPhC CRA MCQ

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ModerateEndocrine TherapeuticsPrednisolone gastroprotection riskGPhC CRA

A 76-year-old patient taking prednisolone 20 mg daily is prescribed naproxen 500 mg twice daily for shoulder pain. She has a history of peptic ulcer disease. What is the most appropriate alternative?

Educational content. Not a substitute for clinical judgement or local policy.

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Correct answer: E — Flag high gastrointestinal bleeding risk and contact the prescriber before supply

NSAIDs increase gastrointestinal bleeding risk, and the risk is higher in older people, with corticosteroids and with previous ulcer disease. Taking NSAIDs after food does not remove this risk. The pharmacist should contact the prescriber to consider avoidance, gastroprotection or an alternative analgesic. Aspirin would not be a safer anti-inflammatory choice here.

Reference: BNF; NICE CKS