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AF rate control in heart failure — GPhC CRA MCQ

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HardCardiovascular TherapeuticsAF rate control in heart failureGPhC CRA

A 70-year-old man with AF is prescribed verapamil modified-release for rate control. His record shows heart failure with reduced ejection fraction and bisoprolol 5 mg daily. BP is 104/66 mmHg and pulse is 58 bpm. What is the most important interaction to flag?

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Correct answer: AQuery the prescription because verapamil is unsuitable with HFrEF and beta-blocker therapy

Verapamil can worsen heart failure with reduced ejection fraction and can cause bradycardia or heart block, especially with beta-blockers. This patient already has a low pulse and low-normal BP. The prescriber should review rate-control choice before supply. The pharmacist should not independently stop or substitute cardiac medicines.

Reference: BNF; NICE CKS