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Spironolactone CKD monitoring — GPhC CRA MCQ

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EasyRenal and Hepatic ImpairmentSpironolactone CKD monitoringGPhC CRA

A man with CKD takes spironolactone and ramipril; the GP increases spironolactone dose. What monitoring is required?

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Correct answer: E — Check serum potassium and renal function soon after the dose change

Potassium-sparing diuretics and ACE inhibitors increase hyperkalaemia risk, especially in CKD. In this scenario, the pharmacist should prioritise safe supply, appropriate counselling and timely referral or clarification where needed. This is the single best answer because the other options would either delay assessment, ignore a clinically significant risk, or create an unsafe legal or professional outcome.

Reference: BNF; NICE CKS