QuestionSBA
QuestionChoice
Metformin does not commonly cause dizziness.
50157
b
Metformin 500mg PO BD
QuestionChoice
Cholecalciferol does not commonly cause dizziness.
50160
e
Cholecalciferol 800U OD
QuestionChoice
Gliclazide does not commonly cause dizziness.
50158
c
Gliclazide 80mg PO OD
QuestionChoice
Chlorphenamine is a H1 antagonist used to treat hayfever. It can commonly cause drowsiness and dizziness; the latter is more likely when taken with oxybutynin as there is a higher risk of antimuscarinic side effects.
50156
a
Chlorphenamine 10mg PO PRN
QuestionChoice
Paracetamol does not commonly cause dizziness.
50159
d
Paracetamol 1g PO BD
QuestionComment
would hypoglycaemia due to Gliclazide not be a concern?
16804
QuestionComment
It is of concern, but the question specifically asks for an interaction with oxybutynin (at least it's stated like this right now)
61678
User
subscriber
Botox Ben
User
subscriber
Fever Metabolism
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
3611
Interaction between oxybutynin and alendronic acid which increases the risk of dizziness.
Topic
130
Geriatrics
10079
Case Presentation: A 82-year-old woman attends her GP. She has been feeling dizzy since being started on Oxybutynin for urge incontinence. Her regular medicines are listed (below).


**PH** Osteoporosis, Type 2 Diabetes Mellitus, Hayfever Overactive Bladder

**DH** Alendronic acid 10mg PO once weekly, Metformin 500mg PO BD, Gliclazide 80mg PO OD, Paracetamol 1g PO BD, Chlorphenamine 10mg PO PRN, Cholecalciferol 800U OD

**On examination**
BP 136/76mmHg, HR 71, RR 14, Weight 50kg

**Investigation**

Neurological examination is normal.

Question: Select the prescription that is most likely to interact with the patient’s oxybutynin to cause dizziness.
a