A 76-year-old man with known heart failure (LVEF 28%) presents with worsening breathlessness and peripheral oedema despite Furosemide 80 mg OD. His we...

Question

A 76-year-old man with known heart failure (LVEF 28%) presents with worsening breathlessness and peripheral oedema despite Furosemide 80 mg OD. His weight has increased by 5 kg in 2 weeks. His eGFR is 42 and potassium is 4.6 mmol/L. What is the MOST appropriate diuretic adjustment?

Accepted Answer

Increase Furosemide to 80 mg BD

Answer

Switch to Bendroflumethiazide 2.5 mg daily

Answer

Add Metolazone 2.5 mg daily for 2-3 days alongside Furosemide

Answer

Stop Furosemide and start Spironolactone 50 mg instead

Answer

Add intravenous Dopamine to improve renal perfusion

uk-dgm MCQ (SBA): Diuretic Dose Optimisation in Heart Failure

A 76-year-old man with known heart failure (LVEF 28%) presents with worsening breathlessness and peripheral oedema despite Furosemide 80 mg OD. His weight has increased by 5 kg in 2 weeks. His eGFR is 42 and potassium is 4.6 mmol/L. What is the MOST appropriate diuretic adjustment?