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Hyperkalaemia risk with ARBs — GPhC CRA MCQ

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HardCardiovascular TherapeuticsHyperkalaemia risk with ARBsGPhC CRA

A 50-year-old with hypertension and type 2 diabetes is prescribed candesartan 8 mg daily. Baseline potassium is 5.3 mmol/L and eGFR is 72 mL/min/1.73 m². Which finding should determine whether treatment is initiated?

Educational content. Not a substitute for clinical judgement or local policy.

Reveal the answer and explanation

Correct answer: E — The potassium concentration above the usual initiation threshold

A renin–angiotensin system antagonist should not normally be initiated when the pretreatment potassium concentration is above 5.0 mmol/L until the cause has been addressed and the result reviewed. Preserved eGFR does not remove the hyperkalaemia risk. The pharmacist should therefore contact the prescriber rather than supply routinely or independently alter the dose.

Reference: https://www.pharmacyregulation.org/students-and-trainees/pharmacist-education-and-training/registration-assessment