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SGLT2 inhibitor sick-day risk — GPhC CRA MCQ

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HardEndocrine TherapeuticsSGLT2 inhibitor sick-day riskGPhC CRA

A 48-year-old woman taking empagliflozin 10mg daily for type 2 diabetes asks for cystitis sachets. She has fever, loin pain, vomiting and her urine dip at the pharmacy health check shows ketones. She has eaten little today. What is the most appropriate action?

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Correct answer: D — Refer urgently because of possible pyelonephritis or ketoacidosis risk

SGLT2 inhibitors are associated with ketoacidosis risk, sometimes with modest glucose elevation, especially during acute illness and reduced intake. Fever and loin pain also suggest upper UTI rather than uncomplicated cystitis. The patient needs urgent medical assessment and sick-day advice.

Reference: BNF; NICE CKS