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Carbimazole agranulocytosis — GPhC CRA MCQ

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HardEndocrine TherapeuticsCarbimazole agranulocytosisGPhC CRA

A 36-year-old woman started carbimazole 20mg daily 3 weeks ago. She phones the pharmacy with a sore throat, mouth ulcers and a temperature of 38.2C. Her next endocrine appointment is in 6 weeks. What monitoring is required?

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Correct answer: C — advise her to stop carbimazole and seek urgent full blood count assessment

Carbimazole can cause agranulocytosis, which may present with sore throat, fever or mouth ulcers. The patient should stop carbimazole and seek urgent medical assessment including a full blood count. Continuing or simply reducing the dose could delay recognition of a serious adverse reaction. The pharmacist cannot manage this safely with symptomatic treatment alone.

Reference: BNF; NICE CKS: Hyperthyroidism