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LABA without ICS in asthma — GPhC CRA MCQ

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HardRespiratory TherapeuticsLABA without ICS in asthmaGPhC CRA

A 29-year-old with asthma presents a repeat prescription for salmeterol 50 micrograms twice daily. The dispensing record and shared care record show no inhaled corticosteroid for six months; the patient uses salbutamol most days and wakes twice weekly. What should the pharmacist do?

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Reveal the answer and explanation

Correct answer: D — Pause dispensing and urgently clarify an inhaled-corticosteroid-containing regimen with the prescriber

Explanation lettering: E = shown as C · C = shown as E

A is wrong because inhaled corticosteroids are not supplied OTC and treatment should not be improvised. B is wrong because LABA monotherapy removes essential anti-inflammatory treatment and is unsafe in asthma. C substitutes frequent SABA use, which also fails to address inflammation. D is correct: the apparent LABA-only regimen plus poor control warrants prompt prescriber clarification and restoration of guideline-concordant ICS-containing therapy. E dangerously escalates LABA exposure without addressing the missing controller.

Reference: NICE NG245: Asthma—recommendations. https://www.nice.org.uk/guidance/ng245/chapter/Recommendations