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Inhaler technique review — GPhC CRA MCQ

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EasyRespiratory TherapeuticsInhaler technique reviewGPhC CRA

A pharmacist is conducting a medication use review for a 72-year-old man with COPD. He is using tiotropium Respimat 2.5 micrograms two puffs once daily but reports minimal benefit. On questioning, he describes spraying the inhaler towards his open mouth without coordinating a slow deep inhalation. What is the most likely reason for poor symptom control?

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Correct answer: D — Poor inhaler technique is resulting in inadequate drug delivery to the lungs

Poor inhaler technique is one of the most common reasons for apparent treatment failure in COPD and asthma. The Respimat device requires a slow deep inhalation coordinated with actuation, with breath-holding for up to 10 seconds afterwards. Simply spraying toward the open mouth without proper inhalation results in most of the drug being deposited in the oropharynx rather than reaching the lungs. Technique review and correction should be the first intervention.

Reference: NICE NG115 COPD; BNF