A 79-year-old man with CKD stage 3b (eGFR 38) has been taking regular Co-codamol 30/500 for chronic back pain. He has become increasingly constipated ...

Question

A 79-year-old man with CKD stage 3b (eGFR 38) has been taking regular Co-codamol 30/500 for chronic back pain. He has become increasingly constipated and confused over 2 weeks. His renal function has worsened (eGFR now 28). According to STOPP criteria, what TWO actions should be taken?

Accepted Answer

Stop Co-codamol and review with non-opioid alternatives; stop any concurrent nephrotoxic medications and investigate the cause of renal deterioration

Answer

Increase laxatives and continue Co-codamol

Answer

Add Oxycodone as a stronger opioid

Answer

Start a proton pump inhibitor for gastrointestinal protection

Answer

Switch to Diclofenac for better pain control

uk-dgm MCQ (SBA): Codeine Accumulation in Worsening CKD

A 79-year-old man with CKD stage 3b (eGFR 38) has been taking regular Co-codamol 30/500 for chronic back pain. He has become increasingly constipated and confused over 2 weeks. His renal function has worsened (eGFR now 28). According to STOPP criteria, what TWO actions should be taken?