24th April 2024

A 78-year-old gentleman with multiple comorbidities, including atrial fibrillation, hypercholesterolaemia, asthma, acne rosacea and rheumatoid arthritis, is admitted from a residential care home with confusion, increased wheezing and vomiting.

A 78-year-old gentleman with multiple comorbidities, including atrial fibrillation, hypercholesterolaemia, asthma, acne rosacea and rheumatoid arthritis, is admitted from a residential care home with confusion, increased wheezing and vomiting. His blood tests show acute kidney injury stage 1 with hypokalemia, raised creatinine, urea and reduced eGFR. His ECG is abnormal, showing slow atrial fibrillation with premature ventricular complexes and a reverse tick sign. You suspect digoxin toxicity precipitated by hypokalaemia and review his medication list for possible drug interactions and nephrotoxic agents. Which of the following medications does not affect digoxin concentrations?

Select the SINGLE most appropriate option from the list below. Select ONE option only.