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Duplicate anticoagulation — DGM MCQ

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HardPolypharmacyDuplicate anticoagulationDGM

An 81-year-old woman is discharged after a pulmonary embolism and returns with extensive bruising. Her discharge list shows two anticoagulants supplied by mistake. Renal function is stable and haemoglobin has fallen. Current medicines include apixaban, dalteparin, ramipril and atorvastatin. Which medication should be reviewed?

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Correct answer: C — Apixaban and dalteparin duplication

Concurrent therapeutic anticoagulants without a bridging indication create major bleeding risk and require urgent medicines reconciliation. Ramipril, atorvastatin, paracetamol and colecalciferol do not explain duplicate anticoagulation and acute bruising. Transitions of care are high-risk points for prescribing errors.

Reference: NICE NG56; BNF