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NSAID gastroprotection — GPhC CRA MCQ

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ModerateMusculoskeletal TherapeuticsNSAID gastroprotectionGPhC CRA

A 69-year-old with osteoarthritis is prescribed naproxen 500 mg twice daily for four weeks. His history includes a previous peptic ulcer and hypertension treated with ramipril. No gastroprotection is prescribed. What is the most appropriate action?

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Correct answer: D — Query the prescription and recommend gastroprotection if NSAID is used

Older age and previous peptic ulcer increase gastrointestinal risk with NSAIDs. If an NSAID is necessary, gastroprotection such as a proton pump inhibitor is commonly required and renal and blood pressure risks should be considered. Adding ibuprofen would increase harm without clear benefit. Aspirin does not protect the stomach and would increase bleeding risk.

Reference: BNF; NICE CKS