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Inhaled steroid mouth soreness — GPhC CRA MCQ

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HardRespiratory TherapeuticsInhaled steroid mouth sorenessGPhC CRA

A patient using high-dose budesonide through a spacer has sore white oral plaques that wipe off and leave an erythematous surface. He has not rinsed after doses. Which management is most appropriate?

Educational content. Not a substitute for clinical judgement or local policy.

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Correct answer: E — Continue budesonide, treat candidiasis and rinse and spit after doses

The presentation is consistent with oral candidiasis. It should be assessed and treated with a suitable antifungal while needed inhaled budesonide usually continues. Rinsing the mouth or brushing teeth after each dose, spitting out the water, and checking spacer and inhaler technique reduce recurrence. Abrupt withdrawal can destabilise asthma.

Reference: NHS, Side effects of budesonide inhalers: https://www.nhs.uk/medicines/budesonide-inhalers/side-effects-of-budesonide-inhalers/