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The diagnosis of renal tubular acidosis had been considered and subsequent disclosure of excessive chronic ingestion of ibuprofen suggested this to be the underlying cause. The striking feature of our patient was the insidious development of the problem and delayed accurate drug history. An important safety message arising from our case is the composite risk of dependence on the opiate component of over the counter analgesics, such as Nurofen Plus, and adverse events related to the ibuprofen component.<\/jats:p>","DOI":"10.1136\/bcr-2019-231403","type":"journal-article","created":{"date-parts":[[2019,11,28]],"date-time":"2019-11-28T05:15:32Z","timestamp":1574918132000},"page":"e231403","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":5,"title":["Impaired consciousness, hypokalaemia and renal tubular acidosis in sustained Nurofen Plus abuse"],"prefix":"10.1136","volume":"12","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-9894-0089","authenticated-orcid":false,"given":"Rebecca","family":"Li","sequence":"first","affiliation":[{"name":"Intensive Care Unit, Royal Berkshire NHS Foundation Trust, Reading, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Neda","family":"Hasan","sequence":"additional","affiliation":[{"name":"Intensive Care Unit, Royal Berkshire NHS Foundation Trust, Reading, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Luke","family":"Armstrong","sequence":"additional","affiliation":[{"name":"Intensive Care Unit, Royal Berkshire NHS Foundation Trust, Reading, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jerome","family":"Cockings","sequence":"additional","affiliation":[{"name":"Intensive Care Unit, Royal Berkshire NHS Foundation Trust, Reading, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[2019,11,27]]},"reference":[{"key":"2025082802092877000_12.11.e231403.1","doi-asserted-by":"crossref","unstructured":"Brok J , Buckley N , Gluud C , et al . 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