A 82-year-old woman with osteoarthritis and chronic pain has been on Co-codamol 30/500 QDS for 3 years. She is also taking Senna 15 mg at night, Lactu...

Question

A 82-year-old woman with osteoarthritis and chronic pain has been on Co-codamol 30/500 QDS for 3 years. She is also taking Senna 15 mg at night, Lactulose 15 mL BD, and Omeprazole 20 mg daily. She is constipated, cognitively slower, and has had two falls in the past month. According to STOPP/START criteria and good practice, which change is MOST appropriate?

Accepted Answer

Consider a structured opioid reduction plan with alternative analgesia (e.g., topical NSAIDs, Paracetamol monotherapy) and review all contributing medications

Answer

Increase Senna to 30 mg BD

Answer

Add Movicol to her current laxative regimen

Answer

Switch Co-codamol to Tramadol 50 mg QDS

Answer

Add Docusate sodium to soften stools

uk-dgm MCQ (SBA): Opioid Deprescribing in Older People