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Spironolactone hyperkalaemia — GPhC CRA MCQ

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ModerateCardiovascular TherapeuticsSpironolactone hyperkalaemiaGPhC CRA

A 69-year-old woman with heart failure is prescribed spironolactone 25 mg daily in addition to ramipril. Her latest potassium is 5.4 mmol/L. What monitoring is required?

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

Reveal the answer and explanation

Correct answer: B — Check potassium and renal function promptly and query suitability before supply

Spironolactone can cause hyperkalaemia, particularly when combined with ACE inhibitors. A potassium of 5.4 mmol/L warrants caution and prescriber discussion before starting or continuing treatment. Renal function should also be reviewed.

Reference: BNF; NICE CKS