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Worsening angina referral — GPhC CRA MCQ

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EasyCardiovascular TherapeuticsWorsening angina referralGPhC CRA

A 60-year-old man presents a repeat prescription for glyceryl trinitrate (GTN) sublingual spray 400 micrograms. He says he has been using it 4-5 times daily for the past week for chest pain on exertion. What is the most appropriate action?

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Correct answer: D — Refer him urgently to the GP as frequent GTN use suggests poorly controlled or worsening angina

Frequent use of GTN spray (more than 2-3 times per week for symptom relief beyond prophylactic use) suggests inadequate control of angina or possible disease progression. This requires urgent GP review for optimisation of anti-anginal therapy and reassessment of cardiovascular risk, including possible referral for further investigation. The pharmacist should not adjust the anti-anginal regimen independently.

Reference: NICE CKS Angina; BNF