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ACE inhibitor monitoring — GPhC CRA MCQ

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EasyCardiovascular TherapeuticsACE inhibitor monitoringGPhC CRA

A GP asks whether ramipril 2.5 mg daily can be started for a 54-year-old patient with hypertension. Baseline potassium is 4.8 mmol/L and eGFR is 76 mL/min/1.73 m². The patient also takes atorvastatin and metformin. What monitoring is required?

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Correct answer: D — Check renal function and electrolytes after initiation

ACE inhibitors can cause hyperkalaemia and an acute fall in renal function, particularly after initiation or dose increases. Urea and electrolytes should therefore be checked soon after starting treatment and after titration. INR and digoxin monitoring are not relevant here. Liver function alone would miss the key safety risks.

Reference: BNF; NICE CKS