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Beta-blocker and asthma — GPhC CRA MCQ

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ModerateCardiovascular TherapeuticsBeta-blocker and asthmaGPhC CRA

A 45-year-old woman with asthma controlled on salbutamol and beclometasone presents with a new prescription for propranolol 40mg twice daily for migraine prevention. She reports previous wheeze with beta-blocker eye drops. What is the most appropriate action?

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Correct answer: A — Contact the prescriber before supply because propranolol may worsen bronchospasm

Propranolol is a non-selective beta-blocker and may precipitate bronchospasm in patients with asthma. A previous reaction to beta-blocker eye drops increases concern. The pharmacist should contact the prescriber to consider a safer migraine preventive option. Increasing salbutamol use does not adequately mitigate this risk.

Reference: BNF; NICE CKS