A 24-year-old asthmatic recently started on a fluticasone propionate dry powder inhaler returns with white patches on the tongue and oropharynx. Which single counselling measure most effectively reduces recurrence of this complication?
- A Rinsing the mouth and gargling with water after each inhalation ✓
- B Taking the dose immediately after meals
- C Doubling the dose to achieve faster control
- D Switching to an oral corticosteroid
Correct answer: A. Rinsing the mouth and gargling with water after each inhalation
Explanation
Oropharyngeal candidiasis results from local deposition of corticosteroid on oral and pharyngeal mucosa, impairing local immunity and allowing Candida overgrowth. Rinsing the mouth and gargling after each actuation washes away residual drug and is the standard preventive advice. Using a spacer with metered-dose inhalers also reduces oropharyngeal deposition. Systemic effects such as adrenal suppression are unrelated to this local complication.
Reference: Katzung's Basic and Clinical Pharmacology, 16th ed.
High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP
Written and medically reviewed by the StethoPrep medical team.