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Spironolactone hyperkalaemia — GPhC CRA MCQ

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ModerateCardiovascular TherapeuticsSpironolactone hyperkalaemiaGPhC CRA

A 71-year-old man with heart failure takes ramipril 10mg daily and furosemide 40mg daily. A hospital letter recommends adding spironolactone 25mg daily. His latest potassium is 5.2mmol/L and eGFR is 42mL/min/1.73m2. What is the most appropriate action?

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

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Correct answer: C — Query initiation because of hyperkalaemia risk

Spironolactone increases potassium and the risk is higher with ACE inhibitors and reduced renal function. A potassium of 5.2mmol/L warrants caution and prescriber review before initiation. The pharmacist should check the intended plan and monitoring rather than supplying without intervention.

Reference: BNF; NICE CKS