QuestionSBA
QuestionChoice
Amlopidine is a calcium channel blocker used to treat hypertension. It is not known to interact with clopidogrel.
50153
c
Amlodipine 10mg OD
QuestionChoice
Aspirin is an anti-platelet used in conjunction with clopidogrel in dual antiplatelet therapy. Although used together there is an increased risk of bleeding, the benefits in preventing atherothrombotic events outweigh this risk when used short-term following high-risk TIAs.
50155
e
Aspirin 75mg OD
QuestionChoice
Esomeprazole is a proton pump inhibitor used to treat gastro-oesophageal reflux disease. Esomeprazole has been shown to decrease the efficacy of clopidogrel. Alternatives to esomeprazole such as H2 receptor antagonists should be considered.
50151
a
Esomeprazole 40mg BD
QuestionChoice
Simvastatin is used to treat hypercholesterolaemia and reduce the risk of ischaemic events. Simvastatin is not known to interact with clopidogrel.
50154
d
Simvastatin  40mg OD
QuestionChoice
Ramipril is an angiotensin-converting enzyme inhibitor used to treat hypertension. It is not known to interact with clopidogrel.
50152
b
Ramipril 5mg OD
QuestionComment
The question should be phrased better. Should have said which drug reduces efficacy. 
17632
User
subscriber
Fungal Tyrosine
QuestionComment
This is a good trick question. If you didn't read the stem and blindly searched in the BNF interaction checker, you wouldve probably picked aspirin.

The stem literally says he was discharged on dual antiplatelet therapy. The BNF treatment summary under "Stroke" also states that they should be considered for dual antiplatelet therapy of clopi and aspirin if there is low risk of bleeding.

So the next best option that has a potential interaction would be esomeprazole.

39686
QuestionComment
I was in the midsts of writing a paragraph in rebuttal of your comment @Biopsy Cystic, only to conclude that you're actually right. Esomeprazole is the correct answer. 
61401
User
subscriber
Retake Prophylaxis 
QuestionComment
i read the stem and thought he was discharged on dual antiplatelet and then proceeded to have a reaction to clopi so needed alteration of the dual antiplatelet by the gp and was so confused, i dont think this question is super well worded
61671
User
subscriber
Vaccine Complement
User
subscriber
Biopsy Cystic
QuestionComment
Decreased efficacy is hardly an adverse reaction?
43774
User
subscriber
Acute Botox
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
3610
Clopidogrel and Omeprazole
Topic
92
General Practice
10078
Case Presentation: A 67-year-old man attends GP for follow-up after discharge from hospital following a crescendo TIA. His medications are listed on the right. He is discharged on dual antiplatelet therapy for 90 days.  


**PMH**

* Stroke
* Hypertension
* Hyperlipidaemia
* GORD

**On examination**

* Chest: Clear, RR 18
* HS: S1 S2 + no added sounds

Question: Which of the following medications should the GP consider stopping due to an adverse drug reaction to clopidogrel?
a