A 83-year-old man with a CFS of 5 and known hypertension has been taking Lisinopril 20 mg daily for 10 years. His latest blood tests show eGFR 45, pot...

Question

A 83-year-old man with a CFS of 5 and known hypertension has been taking Lisinopril 20 mg daily for 10 years. His latest blood tests show eGFR 45, potassium 5.9 mmol/L. He is asymptomatic. His previous potassium was 4.8 mmol/L three months ago. What is the MOST appropriate immediate action?

Accepted Answer

Withhold Lisinopril, recheck potassium urgently (within 24-48 hours), perform an ECG to assess for hyperkalaemic changes, and investigate the cause of the rising potassium

Answer

Continue Lisinopril unchanged and recheck in 3 months

Answer

Increase Lisinopril to 40 mg for better blood pressure control

Answer

Start Spironolactone for additional blood pressure lowering

Answer

Prescribe intravenous calcium gluconate

uk-dgm MCQ (SBA): ACE Inhibitor-Induced Hyperkalaemia

A 83-year-old man with a CFS of 5 and known hypertension has been taking Lisinopril 20 mg daily for 10 years. His latest blood tests show eGFR 45, potassium 5.9 mmol/L. He is asymptomatic. His previous potassium was 4.8 mmol/L three months ago. What is the MOST appropriate immediate action?