QUIZ: What’s the Treatment?

A 67-year-old man presents for his annual physical examination. He reports that he is doing well overall with the exception of aching knee pain, which appears to be osteoarthritis. The patient is currently taking chlorthalidone, 12.5 mg daily, and lisinopril, 20 mg daily, for his blood pressure, which is well controlled. He would like to begin treatment for his knee pain and asks whether he can take a nonsteroidal anti-inflammatory drug (NSAID). Which is your answer to him?

Incorrect

The correct answer is “no.” Control of the patient’s blood pressure is being maintained with an angiotensin-converting enzyme inhibitor and a diuretic; if an NSAID were to be added to the regimen, he would be at a significantly increased risk for an adverse renal event. Furthermore, the patient’s age puts him at higher risk for cardiovascular events and adverse gastrointestinal events, both of which would be further elevated by NSAID use. Read the case report—including what the patient was ultimately prescribed for the knee pain—here.

Correct!

The correct answer is “no.” Control of the patient’s blood pressure is being maintained with an angiotensin-converting enzyme inhibitor and a diuretic; if an NSAID were to be added to the regimen, he would be at a significantly increased risk for an adverse renal event. Furthermore, the patient’s age puts him at higher risk for cardiovascular events and adverse gastrointestinal events, both of which would be further elevated by NSAID use. Read the case report—including what the patient was ultimately prescribed for the knee pain—here.