QuestionSBA
QuestionChoice
Amlodipine is a common cause of peripheral oedema. Calcium channel blockers cause oedema by increasing the pressure within capillaries. This in turn causes fluid to leak out which results in peripheral oedema.
50374
a
Amlodipine 5mg PO OD
QuestionChoice
Ramipril does not commonly cause peripheral oedema
50376
c
Ramipril 10mg PO OD
QuestionChoice
Metformin does not commonly cause peripheral oedema
50375
b
Metformin 500mg PO BD
QuestionChoice
Atorvastatin does not commonly cause peripheral oedema
50377
d
Atorvastatin 200mg PO OD
QuestionChoice
Pioglitazone can cause peripheral oedema however this isn't as commonly seen as with amlodipine use.
50378
e
Pioglitazone 30mg PO OD
Concept
Chapter
Osteoporosis, otherwise known as thin bones, is a condition associated with high risk of low trauma fractures due to reduced bone mineral density. Osteoclast activity exceeds osteoblast activity, meaning that bone resorption is occurring at a greater rate than bone formation.

**Symptoms and Signs**

- Generally asymptomatic until a fragility fracture occurs
- Back pain
- Kyphosis (stooped posture)
- Fragility fractures

**Risk factors**

- Female sex
- Increasing age
- Smoking
- Corticosteroid use
- Low BMI (< 20-25kg/m<sup>2</sup>)
- Low body weight (<58kg)
- Vitamin D deficiency

**Protective factors**

- Higher BMI
- Exercise - mechanical loading stimulates bone formation

**Diagnosis**
Osteoporosis can be detected on dual-energy x-ray absorptiometry (DEXA) scan.
A T score of < -2.5 indicates osteoporosis

**Management**

- Fall prevention
- Vitamin D and calcium supplementation
- Hormone replacement therapy (postmenopausal women)
- Oral bisphosphonates
2657
3658
A common side effect of amlodipine is peripheral oedema
Topic
92
General Practice
10129
Case Presentation: A 61-year-old gentleman attends his GP complaining of ankle swelling.  His regular medicines are listed (below). Weight 88kg.


**PH** Type 2 diabetes mellitus, Hypertension, Hypercholesterolaemia

**DH** Metformin 500mg PO BD, Ramipril 10mg PO OD, Amlodipine 5mg PO OD, Atorvastatin 200mg PO OD, Pioglitazone 30mg PO OD

**On examination**
BP 143/85mmHg, HR 74, RR 12, Weight 95kg

**Investigation**
Chest clear, no added breath sounds. Heart sounds I + II present, no added sounds. Abdomen soft and non-tender.

Bilateral pitting oedema in both ankles.

Question: Select the prescription that is most likely to have contributed to the patient's ankle swelling.
a