BMJ 2011: 343: 703 – 752 (8th October)

I was unsurprised to find that Naproxen is not entirely innocent in the whole Infarctiongate scandal of the NSAIDs.  It is, however, the lowest risk NSAID from the CV point of view.  Ibuprofen makes it into second place.  Diclofenac is the riskiest of the ones still on the market, barely behind Rofecoxib for risk.

And I need to rethink the automatic ticking of the B12 and folate boxes in assessment of elderly people with dementia – according to one letter, testing everyone with dementia for B12 deficiency costs over four grand per case detected.  This can be cut by almost two-thirds by testing only those patients with abnormal FBCs, with no loss of sensitivity.  Likewise, picking up low folate in patients with a normal FBC doesn’t seem to be worthwhile – treatment of low folate in demented patients with normal FBC does not alter the course of the dementia.  VDRLs aren’t really helpful either (not that I was ever doing them, but at least I no longer need to worry about that).  The main bloods that were useful were FBCs, TFTs, glucose, and, surprisingly, calcium.

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About Dr Sarah

I'm a GP with a husband and two young children.
This entry was posted in BMJ, Elderly Medicine, Medication, NSAIDs, Uncategorized. Bookmark the permalink.

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