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Inhaler device selection — GPhC CRA MCQ

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HardRespiratory TherapeuticsInhaler device selectionGPhC CRA

A 66-year-old woman using a dry powder inhaler for COPD has worsening symptoms despite collecting it regularly. In the consultation, she cannot generate a strong inhalation and has arthritis affecting hand grip. What is the most appropriate alternative?

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

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Correct answer: E — Refer for inhaler review and consider an MDI with spacer or soft mist device if clinically suitable

Dry powder inhalers require adequate inspiratory flow. Poor inspiratory effort and hand arthritis suggest the device may be unsuitable, even if adherence appears good. An MDI with spacer or other device may be more appropriate after clinical review and technique assessment. DPIs cannot be used with spacers and inhaled products should not be swallowed.

Reference: BNF; NICE CKS