osteoarthritis+injury+NSAID

=Injury in Man Suffering Osteoarthritis =

//A woman comes into your pharmacy requesting diclofenac (Voltaren gel) for her father (60-70yr old), who has a sore knee from playing lawn bowls.//

Problem
You need to be able to relay information about the patient to determine if diclofenac is required for the injury/soreness

Questions to Ask
How (and when) did your father sustain his injury? //playing lawn bowls a day or two ago// What kind of injury does he have? //just a sore knee that the Voltaren can fix// What medical conditions does your father have? //asthma and osteoarthritis// And what medications is he taking for those? //preventer (with perfect compliance),// long-acting paracetamol //and diclofenac// How well is the asthma controlled? //not too well, although he takes his preventer medication as he is required//

What to do
A few issues have arisen after asking a few introductory questions: - is the gel really necessary? //the analgesics for his osteoarthritis should be sufficient for a sore knee (if not, refer) -// a few issues concerning his diclofenac (paracetamol is first-line, diclofenac gel would be adding more NSAID, contradiction with his asthma medication [similar to aspirin-induced asthma])

The main issue is the diclofenac interfering with his asthma medications, so ensure that he gets his osteoarthritis medications sorted with the GP. Also, the background analgesic should be sufficient for his sore knee, although if needed, __replace__ some of his long-acting paracetamol with paracetamol + codeine. Using NSAID may impair wound healing and interfere with asthma. Offer a self-care card for RICER.

Resources
[|RICER / No HARM]