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Thiazide-like diuretic hyponatraemia — GPhC CRA MCQ

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HardCardiovascular TherapeuticsThiazide-like diuretic hyponatraemiaGPhC CRA

A patient with hypertension is prescribed indapamide 2.5mg daily. Two weeks later he reports severe dizziness and confusion. Blood tests show sodium 124mmol/L, potassium 3.2mmol/L and creatinine within range. What is the most appropriate action?

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Correct answer: A — Refer urgently and withhold further doses pending prescriber advice

Thiazide-like diuretics can cause significant hyponatraemia and hypokalaemia. Sodium 124mmol/L with confusion is clinically important and requires urgent assessment. Continuing or increasing the diuretic would be unsafe. Dietary potassium advice does not address severe hyponatraemia or neurological symptoms.

Reference: BNF; NICE CKS Hyponatraemia