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Heart failure beta-blocker initiation — GPhC CRA MCQ

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ModerateCardiovascular TherapeuticsHeart failure beta-blocker initiationGPhC CRA

A 72-year-old with stable heart failure with reduced ejection fraction is taking ramipril and furosemide. The GP asks which medicine should be introduced next if there is no acute decompensation. What is the most appropriate alternative?

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

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Correct answer: D — Bisoprolol 1.25 mg once daily

Evidence-based beta-blockers are introduced at low dose and titrated in stable heart failure. Starting low reduces the risk of bradycardia and worsening symptoms. In this scenario, the correct option is bisoprolol 1.25 mg once daily. 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; NICE CKS