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Heart failure NSAID request — GPhC CRA MCQ

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EasyCardiovascular TherapeuticsHeart failure NSAID requestGPhC CRA

A 76-year-old with heart failure takes furosemide, ramipril and bisoprolol. They ask to buy ibuprofen for knee pain after a flare of osteoarthritis. What is the most appropriate action?

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

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Correct answer: E — Decline ibuprofen and recommend safer analgesia with prescriber review if needed

NSAIDs can worsen fluid retention, renal function and heart failure control, especially with ACE inhibitors and diuretics. In this vignette, "Decline ibuprofen and recommend safer analgesia with prescriber review if needed" is the safest single best answer. The other options are less appropriate because they miss the key clinical risk, conflict with UK medicines guidance, or delay needed review.

Reference: BNF; NICE CKS