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SABA overuse — GPhC CRA MCQ

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HardRespiratory TherapeuticsSABA overuseGPhC CRA

A 32-year-old with asthma uses low-dose ICS/formoterol MART. Symptoms occur most days and wake her weekly despite confirmed adherence, correct inhaler technique and management of rhinitis. She is not having an acute attack today. What is the next pharmacological step?

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Correct answer: B — Increase to moderate-dose ICS/formoterol MART after documenting the completed control review

For people aged 12 and over whose asthma is not controlled on low-dose MART, current NICE guidance recommends moderate-dose MART after adherence, technique, alternative diagnoses and modifiable factors have been addressed. Scheduled SABA or SABA-only treatment would move away from the anti-inflammatory reliever pathway. Maintenance oral corticosteroids are not the next routine step and have substantial long-term harms.

Reference: NICE NG245: Asthma diagnosis, monitoring and chronic asthma management: https://www.nice.org.uk/guidance/ng245/chapter/recommendations