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Sick day advice for ACE inhibitors — GPhC CRA MCQ

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ModerateCardiovascular TherapeuticsSick day advice for ACE inhibitorsGPhC CRA

A 71-year-old man taking ramipril and metformin asks for advice after 24 hours of vomiting and poor fluid intake. He is passing less urine than usual but has no chest pain or breathlessness. What would you advise the patient?

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

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Correct answer: C — Seek medical advice and temporarily withhold medicines that worsen dehydration-related kidney injury if advised

Vomiting and dehydration increase the risk of acute kidney injury with medicines such as ACE inhibitors, diuretics, NSAIDs and metformin. The patient should be signposted for clinical advice, particularly with reduced urine output. Extra ACE inhibitor or potassium supplementation would be unsafe.

Reference: NICE CKS; BNF