QuestionSBA
QuestionChoice
Digoxin does not commonly cause bleeding
34197
c
Digoxin 125 micrograms PO daily
QuestionChoice
Bisoprolol does not commonly cause bleeding
34196
b
Bisoprolol fumarate 5mg PO daily
QuestionChoice
NSAIDs (indomethacin) and antiplatelet (rivaroxaban) interact to increase the risk of gastrointestinal bleeding. Indomethacin is a non-selective COX inhibitor, its effect on COX-1, in particular, decreases the production of thromboxane A2 and prevents platelet aggregation. When used in combination with antiplatelet or anticoagulant agents, it can increase the bleeding risk in patients
34195
a
Indomethacin 100mg PO BD
QuestionChoice
Ramipril does not commonly cause bleeding
34198
d
Ramipril 2.5mg PO daily
QuestionChoice
Amlodipine does not commonly cause bleeding
34199
e
Amlodipine 10mg PO daily
QuestionComment
rivaroxaban is an anticoagulant not an antiplatelet
7585
User
subscriber
MJ
Concept
Chapter
#### Monitoring

The BNF advises to monitor lung function (in patients with a history of obstructive airway disease).

#### Overdoses

Overdosages with beta-blockers may cause cardiac effects such as bradycardia, hypotension, syncope, conduction abnormalities, and heart failure. Bradycardia is the most common arrhythmia, but some beta-blockers may induce ventricular tachyarrhythmias secondary to prolongation of QT interval (e.g. sotalol) or QRS duration (e.g. propranolol).
Non-cardiovascular effects include central nervous system effects (including drowsiness, confusion, convulsions, hallucinations, and in severe cases coma), respiratory depression, and bronchospasm.

Management
 - Airway protection 
 - Activated charcoal within 1 hour
 - IV Fluids
 
IV glucagon is the first-line management.
 
For symptomatic bradycardia, IV atropine may be used.

2618
2782
Rivaroxaban side effects
Topic
9
Internal Medicine
6850
Case Presentation: A 54-year-old man is admitted to the medical ward with acute gout. PMH AF, gout, hypertension. DH His current regular medicines, in addition to rivaroxaban, are listed on the right.


On examination
Swollen, red and tender left metatarsophalangeal joint.
Dark, black tarry stools reported.

Investigation
FBC Hb 13g/dL (13.5-17.5g/dL)
Fine needle aspiration of joint: negative birefringent urate crystals seen in polarized light.

Question: Select the prescription that is most likely to interact with the patient’s rivaroxaban to cause gastrointestinal bleeding.
a