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Spironolactone hyperkalaemia risk — GPhC CRA MCQ

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ModerateCardiovascular TherapeuticsSpironolactone hyperkalaemia riskGPhC CRA

A patient with heart failure is prescribed spironolactone in addition to ramipril. Their last potassium result was high-normal and they ask whether the combination is safe. What monitoring is required?

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

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Correct answer: A — Check potassium and renal function before and after starting

Combining an ACE inhibitor with spironolactone increases hyperkalaemia risk. Renal function and potassium should be checked at baseline and after initiation or dose changes. In this scenario, the correct option is check potassium and renal function before and after starting. The other options are plausible but do not address the key clinical, legal or safety issue as directly. This aligns with UK pharmacy practice guidance cited in the reference field.

Reference: BNF