Case 12, a primary care example developed by Dr Andrea Clarke, Senior Medical Teacher and GP in Consett.
Mr Taylor is a 76 year old man who has come to see you today complaining of several months of worsening knee pain. Knee pain is worse on walking and during the night is waking him from sleep. You see from his records that he was diagnosed with osteoarthritis of his knees 3 years ago. He has Type 2 Diabetes, Hypertension and Stage 3 Chronic Kidney Disease. He tells you that the paracetamol just aren’t strong enough anymore. He took some over the counter co-codamol but felt nauseous. He has no allergies.
With reference to primary care resources, consider your initial management plan.
What medication might you consider prescribing?
What would you check before issuing any prescription?
In order to get some prescribing resources out there we intend to publish a series of prescribing problems on the website. The problems will appear at least weekly with the "answers" appearing a couple of days later. We'll use the standard exam stationery available on the LSE, but also available below in case you haven't got access to the LSE.