QuestionSBA
QuestionChoice
Amlodipine is a calcium-channel blocker (CCB) used to treat high blood pressure and coronary artery disease. It is taken by mouth. Common side effects include peripheral oedema, feeling tired, abdominal pain, and nausea. Electrolyte disturbances to be aware of, although rare, are hyponatraemia and hyperkalaemia. Hyperkalaemia has only been known to occur in patients who have known kidney disease which this patient does not have.
10001520
d
Amlodipine
QuestionChoice
Atorvastatin is a statin medication taken by mouth. It is used as both primary and secondary prevention of cardiovascular disease in those at high risk of ischaemia and to treat abnormal lipid levels. It is known to increase creatine kinase (CK) levels in patients also taking macrolide antibiotics due to the interaction that causes myopathy. The most reported electrolyte abnormalities related to statins are hypokalemia, hypomagnesemia, and hypocalcemia.
10001518
b
Atorvastatin
QuestionChoice
The patient is presenting with hyperkalaemia. Spironolactone is a potassium-sparing diuretic which is used to offload fluid for patients with oedema and also has antihypertensive effects. Spironolactone competitively inhibits aldosterone-dependant sodium-potassium exchange channels in the distal convoluted tubule. This action leads to increased sodium and water excretion, but more potassium retention, which predisposes patients to hyperkalaemia.
10001517
a
Spironolactone
QuestionChoice
Cetirizine is a second-generation antihistamine used to treat allergic rhinitis, dermatitis, and urticaria. Non-sedating antihistamines such as cetirizine hydrochloride cause less sedation and psychomotor impairment than the older antihistamines. They have not been reported to affect the concentration of electrolytes within the body.
10001521
e
Cetirizine
QuestionChoice
Paracetamol is a medication used to treat fever and mild to moderate pain. Adverse effects include liver impairment, particularly if taken in excessive quantities or if a patient has a body weight <50kg. It is not known to cause electrolyte disturbances.
10001519
c
Paracetamol
Concept
Chapter
2693
3934
hyperkalaemia
Topic
170
Clinical Chemistry
12850
A patient has an ECG performed which shows tall tented T-waves. He is currently on maximum treatment for hypertension and his drug history includes atorvastatin, amlodipine, paracetamol, cetirizine and spironolactone. He has no significant past medical history.

Given the most likely electrolyte abnormality, which of these medications is most likely to be causing this side effect?
a