MICA · General Practice & Urgent Care
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FICTIONAL CASE · SELF-REFLECTION WITHOUT A SCORE
A patient with hypertension taking a diuretic and a renin–angiotensin system inhibitor requests an NSAID for back pain. Diarrhoea has reduced oral intake for two days, and they already take an over-the-counter painkiller.
Which risk immediately changes the decision?
Dehydration, concomitant medicines and possible duplication increase kidney risk. Identify the existing product, assess hydration and consider a suitable alternative. Adding gastroprotection alone does not resolve the problem: prescribing requires an overall risk assessment and monitoring plan.