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NSAID triple whammy MSK — GPhC CRA MCQ

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EasyMusculoskeletal TherapeuticsNSAID triple whammy MSKGPhC CRA

An older woman taking ramipril and bendroflumethiazide with CKD asks for naproxen after vomiting. What is the most appropriate action?

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Correct answer: D — Avoid NSAID supply and advise safer analgesia or review

This scenario assesses NSAID triple whammy MSK in a UK pharmacy practice context. ACE inhibitor, diuretic and NSAID exposure increases acute kidney injury risk, especially with dehydration. The best answer is Avoid NSAID supply and advise safer analgesia or review because it addresses the principal clinical, legal or safety issue before routine supply. The other options are less appropriate because they either miss the key risk, delay necessary review, or would not meet expected BNF, NICE, MEP, MHRA or GPhC practice standards.

Reference: BNF; NICE CKS