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Bisoprolol adherence and pulse — GPhC CRA MCQ

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HardCardiovascular TherapeuticsBisoprolol adherence and pulseGPhC CRA

A patient with stable heart failure takes bisoprolol 10 mg daily and now reports presyncope. Their sitting pulse is regular at 46 beats/min and BP is 102/64 mmHg. What is the best community-pharmacy action?

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Correct answer: E — Refer today for assessment of suspected symptomatic bradycardia

Option E is correct: presyncope with a pulse of 46 suggests symptomatic bradycardia and needs prompt assessment and dose review. Option D ignores the risk of abrupt beta-blocker withdrawal and the possibility of later reintroduction. Option A mistakes rhythm regularity for safety. Option B adds an unsuitable sympathomimetic. Option C preserves the same total dose and does not resolve the adverse effect.

Reference: Bisoprolol SmPC: https://www.medicines.org.uk/emc/product/102395/smpc