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NSAID gastroprotection — GPhC CRA MCQ

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ModerateGastro-intestinal TherapeuticsNSAID gastroprotectionGPhC CRA

A 78-year-old woman with osteoarthritis is prescribed naproxen 500mg twice daily. She has a previous peptic ulcer and takes low-dose aspirin after a stroke. What is the most appropriate alternative?

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

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Correct answer: B — Co-prescribe a proton pump inhibitor and review NSAID suitability

Older age, previous ulcer disease and aspirin use increase gastrointestinal bleeding risk with NSAIDs. Gastroprotection with a PPI and review of NSAID necessity are appropriate. The lowest effective dose for the shortest duration should be considered. Prednisolone and ibuprofen would increase rather than reduce risk.

Reference: BNF; NICE CKS