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ACE inhibitor initiation monitoring — GPhC CRA MCQ

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EasyCardiovascular TherapeuticsACE inhibitor initiation monitoringGPhC CRA

A 63-year-old man is started on ramipril 2.5mg daily for hypertension. His baseline eGFR is 64mL/min/1.73m2 and potassium is 4.6mmol/L. He also takes metformin and atorvastatin. What monitoring is required?

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Correct answer: A — Check renal function and serum potassium within 1 to 2 weeks

ACE inhibitors can increase potassium and reduce eGFR, particularly soon after initiation or dose increases. Baseline renal function is acceptable, but early U&E monitoring is still required. This is also a point to counsel about dehydration and NSAID avoidance.

Reference: BNF; NICE CKS