Montelukast neuropsychiatric warning — GPhC CRA MCQ
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Correct answer: D — Avoid intravenous dantrolene with verapamil because serious cardiovascular collapse has been reported
Explanation lettering: B = shown as A · E = shown as B · A = shown as C · C = shown as E
A invents increased renal elimination and an unsupported dose reduction. B is wrong because the clinically dangerous signal specifically concerns intravenous dantrolene with calcium-channel blockers. C invents antagonism of dantrolene’s mechanism and substitutes an inappropriate treatment. D is correct: product information recommends avoiding intravenous dantrolene with verapamil or diltiazem because cardiovascular collapse has occurred, including fatal ventricular fibrillation in supporting evidence. E is wrong because spacing does not remove the pharmacodynamic interaction.
Reference: Dantrium IV 20 mg SmPC. https://www.medicines.org.uk/emc/product/1097/smpc