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COPD inhaler escalation — GPhC CRA MCQ

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ModerateRespiratory TherapeuticsCOPD inhaler escalationGPhC CRA

A 67-year-old man with COPD remains breathless using salbutamol several times a day. He has no history of asthma and had one exacerbation last year. The GP asks for a maintenance inhaler option. What is the most appropriate alternative?

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Correct answer: A — A long-acting bronchodilator such as tiotropium

Persistent COPD symptoms despite a short-acting bronchodilator usually warrant maintenance long-acting bronchodilator therapy. A LAMA such as tiotropium is a common option. Inhaled corticosteroids are considered for selected patients, often as part of combination therapy depending on exacerbation history and eosinophils. Long-term oral prednisolone is avoided due to harms.

Reference: NICE CKS; BNF