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Sulfonylurea fasting risk — GPhC CRA MCQ

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HardEndocrine TherapeuticsSulfonylurea fasting riskGPhC CRA

A patient with acute coronary syndrome undergoing PCI is prescribed prasugrel. The medicines reconciliation documents an ischaemic stroke five years ago. What should the pharmacist do?

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

Reveal the answer and explanation

Correct answer: D — Withhold and urgently query the prescription because any previous stroke or TIA contraindicates prasugrel

Option D is correct: a history of stroke or transient ischaemic attack is a prasugrel contraindication because of excess bleeding, including intracranial haemorrhage. Option E wrongly limits concern to haemorrhagic stroke. Option B confuses the 5 mg consideration for low body weight or older age with a contraindication. Option A invents a three-month exception. Option C makes an unapproved antiplatelet substitution without the interventional-cardiology team.

Reference: Prasugrel SmPC: https://www.medicines.org.uk/emc/product/14557/smpc