QuestionSBA
QuestionChoice
This should only be offered if IV paracetamol has inadequate analgesic effect.
10035545
d
Oral tramadol
QuestionChoice
NSAIDs are contraindicated in this patient due to his past medical history of peptic ulcer disease with a previous upper GI bleed.
10035543
b
IM diclofenac
QuestionChoice
NICE recommends offering IV paracetamol rather than oral paracetamol if NSAIDs are contraindicated.
10035546
e
Oral paracetamol
QuestionChoice
Whilst NSAIDs are usually recommended as first-line treatment for pain in renal colic, they are contraindicated due to the patient’s past medical history of peptic ulcer disease with a previous upper GI bleed. IV paracetamol is therefore a more appropriate initial analgesic agent to offer.
10035542
a
IV paracetamol
QuestionChoice
NSAIDs are contraindicated in this patient due to his past medical history of peptic ulcer disease with a previous upper GI bleed.
10035544
c
PR diclofenac
Concept
Chapter
2693
6139
Renal colic
Topic
143
Urology
19512
In patients with a history of peptic ulcer disease, intravenous paracetamol is a safer analgesic choice for managing renal colic pain.
A 67-year-old man has severe abdominal pain. He describes it as 7/10 pain which radiates from his right flank down towards his suprapubic area. The patient also states the last few times he has passed urine, it appeared tinged red. He has a past medical history of COPD and peptic ulcer disease, with a previous upper GI bleed 6 years ago.

What is the most appropriate analgesia to offer?
a