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ACE inhibitor monitoring — GPhC CRA MCQ

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EasyCardiovascular TherapeuticsACE inhibitor monitoringGPhC CRA

A 52-year-old man starts ramipril 2.5 mg once daily for hypertension. Baseline eGFR is 72 mL/min/1.73 m² and potassium is 4.7 mmol/L. He also takes bendroflumethiazide. What monitoring is required?

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Correct answer: A — Check renal function and electrolytes after initiation and after dose titration

ACE inhibitors can cause a fall in renal function and hyperkalaemia, especially after initiation or dose increases. Renal function and electrolytes should be checked soon after starting and after titration. The diuretic adds risk of first-dose hypotension and renal changes. INR, HbA1c and peak flow are not the relevant monitoring tests.

Reference: BNF; NICE CKS