A patient using high-dose fluticasone via an Accuhaler dry-powder inhaler has symptomatic oral candidiasis but stable asthma. Which plan best

Question

A patient using high-dose fluticasone via an Accuhaler dry-powder inhaler has symptomatic oral candidiasis but stable asthma. Which plan best addresses the adverse effect without destabilising asthma control?

Accepted Answer

Treat with a topical antifungal while continuing fluticasone; rinse after use and review technique and dose

Answer

Use oral fluconazole prophylactically each month while continuing the same technique and high dose

Answer

Switch immediately to another dry-powder corticosteroid at the same high dose without treating candidiasis

Answer

Continue the Accuhaler, add a spacer to it and use topical antifungal treatment without reviewing the dose

Answer

Temporarily replace fluticasone with salbutamol alone while topical antifungal treatment is given

Oral thrush inhaled steroid — GPhC CRA MCQ

A patient using high-dose fluticasone via an Accuhaler dry-powder inhaler has symptomatic oral candidiasis but stable asthma. Which plan best addresses the adverse effect without destabilising asthma control?