skip to main content

ACE inhibitor monitoring — GPhC CRA MCQ

Instant feedback + full explanation. One question, done properly.

HardCardiovascular TherapeuticsACE inhibitor monitoringGPhC CRA

A patient stable on lithium starts ramipril and one week later develops coarse tremor, vomiting and ataxia. Which interaction is most likely?

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

Reveal the answer and explanation

Correct answer: A — Ramipril reduced lithium clearance and precipitated lithium toxicity

ACE inhibitors can reduce lithium clearance and raise its concentration. Coarse tremor, vomiting and ataxia require lithium to be withheld pending urgent concentration, renal and electrolyte assessment. The interaction can develop despite a previously stable lithium dose.

Reference: BNF: lithium carbonate: https://bnf.nice.org.uk/drugs/lithium-carbonate/