skip to main content

AF rate control in asthma — GPhC CRA MCQ

Instant feedback + full explanation. One question, done properly.

HardCardiovascular TherapeuticsAF rate control in asthmaGPhC CRA

A 67-year-old man with asthma and persistent AF is prescribed propranolol 40mg twice daily for rate control after verapamil caused constipation. He uses salbutamol several times a week and has had two courses of prednisolone this year. What is the most appropriate alternative?

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

Reveal the answer and explanation

Correct answer: B — Discuss a more cardioselective beta-blocker or non-beta-blocker option with the prescriber

Non-selective beta-blockers such as propranolol can worsen bronchospasm and antagonise beta-agonists. Asthma severity and recent exacerbations increase the need for caution. Rate-control therapy should be reviewed with the prescriber, considering a more cardioselective option if a beta-blocker is needed or an alternative class. Supplying extra salbutamol does not mitigate the underlying safety issue.

Reference: BNF; NICE CKS Atrial fibrillation