QuestionSBA
QuestionChoice
Lisinopril can increase the risk of hyperkalaemia if used together with diclofenac. However, it is not known to to interact with diclofenac to cause ulceration or gastrointestinal bleeding
34288
d
Lisinopril 20 mg PO OD
QuestionChoice
Metformin is not known to interact with diclofenac to cause ulceration or gastrointestinal bleeding
34287
c
Metformin hydrochloride 500 mg PO TDS
QuestionChoice
Simvastatin is not known to interact with diclofenac to cause ulceration or gastrointestinal bleeding
34289
e
Simvastatin 40 mg PO nightly
QuestionChoice
Methotrexate is not known to interact with diclofenac to cause ulceration or gastrointestinal bleeding
34286
b
Methotrexate 7.5 mg once weekly
QuestionChoice
Both sertraline and diclofenac can increase risk of bleeding. Hence, it is generally recommended to prescribe a gastroprotective drug such as a proton pump inhibitor in people who are taking non-steroidal anti-inflammatory drugs (NSAID), especially for elderly patients
34285
a
Sertraline 50 mg PO OD
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
2800
SSRI - side effects
Topic
90
Psychiatry
6868
Case presentation: A 55-year-old woman presents to her GP with a 2-month history of upper abdominal pain. He describes the pain as a dull ache that is relieved by food. He also notices three episodes of black, sticky stools. He denies having any change in bowel habits or rapid loss in weight.  

PMH: Depression, Rheumatic arthritis, Type 2 Diabetes Mellitus, Hypertension, Hypercholesterolaemia
DH: Her current regular prescriptions, in addition to Diclofenac 50 mg PO three times daily, are listed below
On examination: Mild epigastric tenderness on palpation. Bowel sounds present. Chest is clear with no added lung sounds. Heart sounds I+II+0.

Question: Select the prescription that is most likely to be contributing to the melaena along with diclofenac?
a