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5th March 2024
A 67-year-old woman is referred to the surgical assessment unit with a 2-day history of severe upper abdominal pain radiating to her back, vomiting and pale stools.
A 67-year-old woman is referred to the surgical assessment unit with a 2-day history of severe upper abdominal pain radiating to her back, vomiting and pale stools.
PMH. Gallstones, hypercholesterolaemia, T2DM, depression, epilepsy, GORD, migraines. DH. See below. NKDA.
On examination
HR 114 / min and regular, BP 135/65 mmHg, temperature 38.2 oC, maximally tender in the epigastric region
Investigations
Serum amylase 882 U/L (30 – 118)
| DATE | DRUG NAME | DOSE | ROUTE | FREQUENCY | PRESCRIBER’S SIGNATURE |
| 10/1/21 | CITALOPRAM | 20mg | ORAL | ONCE DAILY | DR |
| 10/1/21 | METFORMIN | 1g | ORAL | ONCE DAILY | DR |
| 10/1/21 | LANSOPRAZOLE | 15mg | ORAL | ONCE DAILY | DR |
| 10/1/21 | ATORVASTATIN | 20mg | ORAL | ONCE DAILY | DR |
| 10/1/21 | SODIUM VALPROATE | 1.2g | ORAL | ONCE DAILY | DR |
| 10/1/21 | AMITRIPTYLINE | 10mg | ORAL | ONCE DAILY | DR |
| 10/1/21 | SUMATRIPTAN | 50-100mg | ORAL | AS REQUIRED | DR |
Select the TWO medications which are the most likely cause of her condition.
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