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Heart failure beta-blocker initiation — GPhC CRA MCQ

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ModerateCardiovascular TherapeuticsHeart failure beta-blocker initiationGPhC CRA

A patient recently admitted with acute decompensated heart failure is discharged on furosemide. A GP asks when bisoprolol should be introduced. What is the most appropriate action?

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Correct answer: B — Start when clinically stable and euvolaemic, with gradual titration

Evidence-based beta-blockers improve outcomes in heart failure with reduced ejection fraction, but initiation should occur when the patient is stable and not acutely fluid overloaded. Doses are titrated gradually with monitoring of heart rate, blood pressure and symptoms. Starting during decompensation can worsen clinical status. Using the target dose immediately increases intolerance risk.

Reference: https://www.pharmacyregulation.org/registration-assessment#stage-8-order-63