Which of the following would result in an increase in blood pressure?

Choice A reason: Glucocorticoids can cause an increase in blood sugar by stimulating gluconeogenesis and inhibiting insulin action. Therefore, a patient with type 1 diabetes who is taking glucocorticoids will not have no change in blood sugar, but rather a rise in blood sugar.

Choice B reason: Glucocorticoids can cause an increase in blood pressure by promoting sodium and water retention and increasing vascular reactivity. Therefore, a patient with type 1 diabetes who is taking glucocorticoids will not have a decrease in the blood pressure, but rather a possible increase in the blood pressure.

Choice C reason: Glucocorticoids can cause an increase in blood sugar by stimulating gluconeogenesis and inhibiting insulin action. Therefore, a patient with type 1 diabetes who is taking glucocorticoids will have an increase in blood sugar. This is the correct statement that describes the expected effect of glucocorticoids in this patient.

Choice D reason: Glucocorticoids can cause an increase in blood sugar by stimulating gluconeogenesis and inhibiting insulin action. Therefore, a patient with type 1 diabetes who is taking glucocorticoids will not have an increase in the need for carbohydrates, but rather a need for more insulin to control the blood sugar.

Choice A reason: This is not a correct statement. LABAs stand for long-acting beta2-agonists, which are a class of medications that relax the smooth muscles of the airways and improve the airflow in patients with asthma or COPD. However, LABAs do not reduce the risk of asthma-related deaths, and may even increase it if used alone without an inhaled glucocorticoid, which is a type of anti-inflammatory medication.

Choice B reason: This is not a correct statement. LABAs cannot be used on an as-needed basis to treat symptoms, as they have a slow onset of action and a long duration of effect. LABAs are meant to be used as a maintenance therapy to prevent asthma exacerbations, not to relieve acute symptoms. For quick relief of symptoms, patients should use a short-acting beta2-agonist, such as albuterol or salbutamol.

Choice C reason: This is not a correct statement. LABAs are not safer than short-acting beta2 agonists, as they have similar side effects, such as tachycardia, tremors, and hypokalemia. LABAs also have a black box warning that they may increase the risk of asthma-related deaths if used without an inhaled glucocorticoid.

Choice D reason: This is the correct statement. LABAs should be combined with an inhaled glucocorticoid, as this combination has been shown to improve the asthma control, reduce the frequency and severity of exacerbations, and decrease the inflammation and airway hyperresponsiveness. The inhaled glucocorticoid also reduces the risk of adverse effects and mortality associated with LABAs.