Misoprostol

Excellent, misoprostol is a PGE1 analogue. Indeed, it has been shown to be effective at inhibiting gastric acid secretion, increasing mucosal blood flow as well as augmenting the secretion of mucus and bicarbonate. These effects offer effective cytoprotection against the potential detrimental effects of NSAIDs on the GI tract. 

 

Its use has been largely superseded by proton pump inhibitors. However given Mr. Mason's fracture, it is not unreasonable to use misoprostol instead in this case, at least until the investigations for osteoporosis are completed. 

 

Discharge

Map: Connor Mason_UNIC (1100)
Node: 20915
Score:

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OpenLabyrinth
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  • Ramipril
  • Oral prednisolone (glucocorticoid)
  • Nebulized ipratropium (SAMA, anticholinergic)
  • Metolazone
  • Ask the patient to walk or change position (risk of falling).
  • Inhalational fluticasone (glucocorticoid)
  • Intravenous resluzimab (IL-5 antibody)
  • State that assessment cannot continue without a clear image
  • Bisoprolol
  • Ask the patient to take a clear photo of the wound (10–15 cm distance, adequate lighting) and upload it to the app
  • The patient presentation is not due to paracetamol overdose
  • Cholestasis is the most likely diagnosis
  • There is a risk for a thromboembolic event
  • Amoxicillin
  • Delay wound assessment until an in-person visit
  • Ignore the emotional expression.
  • Paracetamol has been metabolized
  • Validate the emotion
  • Poor camera image
  • Blame the patient for non-adherence
  • Lansoprazole
  • Ask the patient to take a clear photo of the wound (10–15 cm distance, adequate lighting) and upload it to the app
  • Respond bluntly: “That is common in diabetes.”
  • Allow only one profession to speak the entire time
  • Epilogue
  • Delay wound assessment until an in-person visit
  • Ask the patient to walk or change position
  • Misoprostol

Reminder

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