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17th May 2025
A 74-year-old man was admitted following a fall at home.
A 74-year-old man was admitted following a fall at home. His family reported a 2-week history of lethargy, confusion, agitation, nausea, and dizziness. His usual medications are Bisoprolol, Omeprazole, Captopril, Metformin, Aspirin, Atorvastatin for atrial fibrillation, gastro-oesophageal reflux disease, hypertension, type 2 diabetes mellitus and previous myocardial infarction.
Investigations:
| Haemoglobin | 105 g/L (130–180) | (13.5-17.5 g/dL) |
| White cell count | 11.5 × 10⁹/L (4.0–11.0) | (4-11×109/L) |
| Serum sodium | 106 mmol/L (137–144) | (150-400×109/L) |
| Serum potassium | 5.0 mmol/L (3.5–4.9) | (135-145 mmol/L) |
| Serum urea | 9.6 mmol/L (2.5–7.0) | (3.5-5 mmol/L) |
| Serum creatinine | 150 μmol/L (60–110) | (50-10 micromol/L) |
| 12-lead ECG | Sinus bradycardia | |
Which medication change should occur?
Select the SINGLE most appropriate option from the list below. Select ONE option only.
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