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Verapamil in heart failure — GPhC CRA MCQ

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HardCardiovascular TherapeuticsVerapamil in heart failureGPhC CRA

A prescription for verapamil modified-release 240 mg daily is presented for a 74-year-old man with atrial fibrillation. The pharmacy record shows heart failure with reduced ejection fraction and current bisoprolol therapy. His wife says he was recently admitted with fluid overload. What is the most appropriate action?

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

Reveal the answer and explanation

Correct answer: D — Withhold supply and contact the prescriber urgently

Verapamil has negative inotropic effects and can worsen heart failure with reduced ejection fraction. Combined use with beta-blockers also increases the risk of bradycardia and atrioventricular block. The pharmacist should not supply until the prescriber has reviewed the safety concern.

Reference: https://www.pharmacyregulation.org/registration-assessment#stage-8-order-74