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Impetigo treatment — GPhC CRA MCQ

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HardInfectionsImpetigo treatmentGPhC CRA

A patient admitted with acute severe asthma is receiving repeated nebulised salbutamol, oral prednisolone and regular theophylline. They are hypoxic and develop muscle weakness with ventricular ectopy; serum potassium is 2.8 mmol/L. Which pharmaceutical recommendation is most appropriate?

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Correct answer: B — Escalate urgently, monitor and correct potassium, and review the additive potassium-lowering treatments

Nebulised beta2 agonists can shift potassium intracellularly and cause serious hypokalaemia. Hypoxia, xanthines, corticosteroids and diuretics can amplify the effect. Potassium of 2.8 mmol/L with weakness and ventricular ectopy requires urgent clinical escalation, ECG and electrolyte monitoring, correction under the acute-care protocol and review of contributing therapy. This is a pharmacological adverse effect rather than allergy. Adding a thiazide would worsen potassium loss, simple reassurance is unsafe, and abruptly stopping necessary exacerbation treatment without coordinated review does not manage the whole risk.

Reference: Salbutamol 2 mg/mL nebuliser solution SmPC. https://www.medicines.org.uk/emc/product/10257/smpc