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Spironolactone initiation — GPhC CRA MCQ

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ModerateCardiovascular TherapeuticsSpironolactone initiationGPhC CRA

A 69-year-old man with heart failure starts spironolactone 25 mg daily in addition to ramipril and furosemide. What monitoring is required?

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

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Correct answer: A — Urea, electrolytes and renal function soon after initiation

This scenario assesses Spironolactone initiation in a UK pharmacy practice context. Spironolactone can cause hyperkalaemia and renal deterioration, especially with ACE inhibitors. The best answer is Urea, electrolytes and renal function soon after initiation because it addresses the principal clinical, legal or safety issue before routine supply. The other options are less appropriate because they either miss the key risk, delay necessary review, or would not meet expected BNF, NICE, MEP, MHRA or GPhC practice standards.

Reference: BNF; NICE CKS