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AKI sick day medicines — GPhC CRA MCQ

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HardRenal and Hepatic ImpairmentAKI sick day medicinesGPhC CRA

A 78-year-old woman taking ramipril, furosemide and metformin has acute vomiting and diarrhoea. Her daughter asks whether to keep giving regular medicines; the patient is dizzy and has not passed urine since morning. What is the most appropriate action?

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Correct answer: C — Refer for urgent assessment and medication review because dehydration may precipitate AKI

Vomiting, diarrhoea, dizziness and oliguria suggest significant dehydration and possible acute kidney injury. ACE inhibitors, diuretics and metformin require review during acute illness because of renal and lactic acidosis risks. The patient needs urgent clinical assessment rather than simple OTC advice. NSAIDs would increase AKI risk.

Reference: BNF; NICE CKS