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Insomnia with opioid and COPD — GPhC CRA MCQ

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ModerateCNS TherapeuticsInsomnia with opioid and COPDGPhC CRA

A 72-year-old woman asks for something to help sleep after bereavement. She has COPD, takes oxycodone MR for cancer pain and drinks two glasses of wine most evenings. What is the most appropriate action?

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Correct answer: C — Refer to the GP and advise non-drug sleep measures

Sedating antihistamines or hypnotics would increase risks of respiratory depression, falls and confusion in this patient. Her opioid use, COPD and alcohol intake make over-the-counter sedatives particularly unsafe. Supportive non-drug advice and prescriber review are more appropriate.

Reference: BNF; NICE CKS