Pharmacology · single question
A patient using a salmeterol inhaler for asthma has missing teeth 5 and 30 with a posterior open bite. The MAIN RISK their salmeterol poses is:
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Correct answer: C. Oropharyngeal candidiasis (from inhaled corticosteroid/LABA deposition in the oropharynx)
- A. High HbA1c is not a direct risk of salmeterol — it is a diabetes monitoring parameter.
- B. Metaplastic transformation is a risk of smoking-related COPD, not salmeterol use.
- C. Correct. Inhaled medications (especially corticosteroids, often combined with LABAs like salmeterol in formulations like Advair/Symbicort) deposit in the oropharynx and can cause LOCAL IMMUNOSUPPRESSION, leading to oropharyngeal CANDIDIASIS. Patients are instructed to rinse their mouth after each use to prevent this. Even salmeterol alone in some formulations carries this risk through the oropharyngeal deposition of the excipient.
- D. Renal failure is not associated with salmeterol.