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COPD rescue pack — GPhC CRA MCQ

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ModerateRespiratory TherapeuticsCOPD rescue packGPhC CRA

A 68-year-old with COPD has increased breathlessness and purulent sputum for two days. Oxygen saturation is their usual 92%, temperature 37.8°C, and a clinician-issued rescue pack contains prednisolone and doxycycline with written criteria matching these symptoms. What should the pharmacist advise?

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Correct answer: C — Start the written rescue pack, notify the team and follow red-flag advice

Start the written rescue pack, notify the team and follow red-flag advice: The documented action plan is designed for this symptom pattern; follow-up checks response and prevents unsupervised repeated courses. Start prednisolone alone and contact the COPD team after the course: Purulent sputum is a recognised criterion for antibiotic treatment in an exacerbation. Start doxycycline alone and continue usual inhaled treatment and monitoring: A short corticosteroid course is appropriate when breathlessness significantly increases. Keep the rescue pack sealed and arrange routine review in two weeks: The action plan authorises timely treatment and delay risks deterioration. Increase both written doses on day one and then resume the instructions: Dose escalation outside the written plan increases harm without evidence of benefit.

Reference: NICE NG115: COPD in over 16s: https://www.nice.org.uk/guidance/ng115/chapter/Recommendations; BNF: prednisolone: https://bnf.nice.org.uk/drugs/prednisolone/