Paper I
2019 July (Supplementary) (2010 Scheme) · 40 marks · 120 min

Question

Thiazides / Spironolactone in patients using Lisinopril Name the following (Two examples for each): (5x1=5)

Q150.3 marksShort Answers

Answer

Chosen drug: Thiazides (with caution/monitoring)

Justification: Both thiazides and spironolactone can be used with ACE inhibitors (Lisinopril), but the combination of spironolactone (a potassium-sparing diuretic) with an ACE inhibitor carries a significant risk of dangerous hyperkalaemia, since ACE inhibitors also reduce aldosterone-mediated potassium excretion. Thiazides, being kaliuretic (potassium-wasting) diuretics, do not compound this risk and are generally the safer combination for routine add-on diuretic therapy with an ACE inhibitor, though electrolytes should still be monitored. (Spironolactone may still be used with ACE inhibitors in specific settings like heart failure, but only with close potassium monitoring.)

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