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Stimulant cardiovascular monitoring — GPhC CRA MCQ

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ModerateCNS TherapeuticsStimulant cardiovascular monitoringGPhC CRA

A 30-year-old man with a diagnosis of ADHD is prescribed lisdexamfetamine 30 mg daily. He also takes citalopram 20 mg daily for anxiety. He reports intermittent palpitations. What is the most appropriate pharmacist action?

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Correct answer: D — Refer to the prescriber for cardiovascular assessment including ECG and blood pressure monitoring

Stimulant medications including lisdexamfetamine can increase heart rate and blood pressure. Palpitations should not be dismissed, particularly when the patient is also taking a medication that can affect cardiac conduction (citalopram can prolong QT). The patient should be referred for cardiovascular assessment including ECG, heart rate, and blood pressure monitoring. NICE ADHD guidelines recommend baseline and ongoing cardiovascular monitoring with stimulant medications.

Reference: NICE NG87 ADHD; BNF