6th May 2025

A 75-year-old woman with known chronic heart failure is admitted to the Cardiology ward with increased JVP, bibasal crepitations and pitting oedema to bilateral anterior superior iliac spines.

A 75-year-old woman with known chronic heart failure is admitted to the Cardiology ward with increased JVP, bibasal crepitations and pitting oedema to bilateral anterior superior iliac spines. After 2 days of treatment with intravenous diuretics, her observations are as follows: pulse 73 beats per minute, blood pressure 143/87mmHg, respiratory rate of 19 and oxygen saturation of 94% on room air. She is already on bisoprolol 10mg OD, furosemide 80 mg BD and ramipril 10mg OD. Her current urea and electrolyte test shows sodium of 131 mmol/L, potassium of 4.2mmol/L, urea of 4.0 and creatinine of 110 umol/L.  

Which of the following drugs would be most appropriate to add to her current regime?

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