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Medication fall anticoagulant risk — DGM MCQ

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HardFallsMedication fall anticoagulant riskDGM

An 87-year-old man has recurrent falls and recent melaena. He is anaemic and takes treatment for atrial fibrillation and knee pain. Blood pressure is stable; no fracture is present. Current medicines include rivaroxaban, ibuprofen and lansoprazole. Which medication should be reviewed?

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Correct answer: C — Ibuprofen

Ibuprofen increases gastrointestinal bleeding and renal risk in an older person, especially with anticoagulation, and should be reviewed urgently. Rivaroxaban may need risk-benefit review but the NSAID is the avoidable bleeding trigger; lansoprazole, paracetamol and colecalciferol are less concerning. Falls review should include medicines that increase harm from falls as well as medicines that cause falls.

Reference: STOPP/START criteria v3; BNF