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COPD inhaler choice — GPhC CRA MCQ

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ModerateRespiratory TherapeuticsCOPD inhaler choiceGPhC CRA

A 73-year-old woman with COPD remains breathless on salbutamol as needed. She has no asthma features and has had no exacerbations in the last year. Her blood eosinophils are not raised. What is the most appropriate alternative?

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

For persistent COPD breathlessness, a long-acting bronchodilator is usually the next maintenance step. Inhaled corticosteroid monotherapy is not appropriate for COPD and carries pneumonia risk. The choice of LAMA, LABA or combination depends on symptoms, exacerbation history and local guidance.

Reference: NICE CKS; BNF