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Spironolactone in renal impairment — GPhC CRA MCQ

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ModerateRenal and Hepatic ImpairmentSpironolactone in renal impairmentGPhC CRA

A patient with chronic kidney disease and heart failure has potassium 5.9 mmol/L while taking spironolactone and ramipril. He asks to collect both medicines. What is the most appropriate action?

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

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Correct answer: A — Withhold and contact the prescriber urgently about hyperkalaemia

Spironolactone and ACE inhibitors can both raise potassium, especially in chronic kidney disease. A potassium of 5.9 mmol/L is unsafe and needs urgent clinical review. The other options either delay appropriate care, use an unsuitable medicine, or miss the main safety issue.

Reference: BNF; NICE CKS