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COPD maintenance treatment — GPhC CRA MCQ

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ModerateRespiratory TherapeuticsCOPD maintenance treatmentGPhC CRA

A 69-year-old ex-smoker has COPD with persistent breathlessness despite salbutamol. Spirometry confirms airflow obstruction and his eosinophil count is not raised. He has no childhood asthma history and no recent exacerbations. What is the most appropriate alternative?

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Correct answer: C — a LABA/LAMA inhaler

For COPD with persistent breathlessness and no asthmatic features, a dual long-acting bronchodilator inhaler is an appropriate maintenance option. Inhaled corticosteroid monotherapy is not standard COPD maintenance treatment and carries pneumonia risk. Long-term oral corticosteroids should be avoided where possible. Montelukast is not a usual COPD maintenance option.

Reference: BNF; NICE CKS: COPD