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ICS adverse effects in COPD — GPhC CRA MCQ

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HardRespiratory TherapeuticsICS adverse effects in COPDGPhC CRA

A 72-year-old man using fluticasone/salmeterol and tiotropium reports hoarseness and two courses of oral thrush treatment in 4 months. He also has pneumonia documented 6 weeks ago. What is the most appropriate action?

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Correct answer: C — Refer for COPD treatment review and assess inhaler technique

Repeated oral candidiasis and recent pneumonia can be associated with inhaled corticosteroid exposure, particularly in COPD. The pharmacist should check technique and adherence, but repeated adverse effects warrant prescriber review of the regimen and indication. Continuing to treat thrush alone misses a wider medicines optimisation issue.

Reference: BNF; NICE CKS