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Heart failure monitoring — GPhC CRA MCQ

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HardCardiovascular TherapeuticsHeart failure monitoringGPhC CRA

A 74-year-old woman presents a discharge prescription for ramipril 2.5 mg daily and spironolactone 25 mg daily after admission with heart failure with reduced ejection fraction. Her discharge bloods show eGFR 46 mL/min/1.73 m2 and potassium 5.1 mmol/L. What monitoring is required?

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Correct answer: A — Check U&Es and renal function within 1 week

ACE inhibitors and mineralocorticoid receptor antagonists both increase the risk of hyperkalaemia and renal deterioration. Baseline results already show borderline potassium, so early U&Es after initiation or dose change are important. The pharmacist should ensure the monitoring plan is in place and counsel the patient to avoid potassium-containing salt substitutes.

Reference: BNF; NICE CKS