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Heart failure and OTC NSAID — GPhC CRA MCQ

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ModerateCardiovascular TherapeuticsHeart failure and OTC NSAIDGPhC CRA

A 74-year-old man with heart failure takes ramipril, bisoprolol and furosemide. He asks to buy ibuprofen for knee pain and reports increased ankle swelling. What is the most appropriate action?

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

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Correct answer: B — Avoid OTC ibuprofen and refer for safer analgesia

This scenario assesses Heart failure and OTC NSAID in a UK pharmacy practice context. NSAIDs can worsen fluid retention, renal function and heart failure control, particularly with ACE inhibitors and diuretics. The best answer is Avoid OTC ibuprofen and refer for safer analgesia 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