275) A 70 year old obese woman is evaluated in your office during an annual follow up visit. She has a history of moderate osteoarthritis and she takes over the counter ibuprofen for arthritis pain. She was recently hospitalized with one episode of gastro-intestinal bleeding about 6 months ago. She is being maintained on a proton pump inhibitor. Her other medical problems include hypertension and a history of transient ischemic attack about 2 months ago. Upon review of her medications, you note that she is not on any antiplatelet therapy. Physical examination is unremarkable. Which of the following recommendations is most appropriate management for this patient?
A) Warfarin
B) Aspirin and Dipyridamole
C) Aspirin
D) Clopidogrel
E) Dipyridamole
F) No anti-platelet therapy
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C
D. Clopidogrel said to have lesser risk of GI bleed than Aspirin. No RCTs available.
Aspirin plus PPI prevents GI bleeding. C is the choice
D…..
http://www.rxfacts.org/pdf/APLT%20RYG%20Ref.%20card.pdf
D: GI bleeding is stronger associated for ASA.