MEDICAL

AN 18 YEAR OLD MAN WITH ASTHMA HAS GRADUALLY INCREASING BREATHLESSNESS AND WHEEZE DESPITE REGULAR USE OF HIS SALBUTAMOL AND CORTICOSTEROID INHALERS. WHICH IS THE MOST APPROPRIATE NEXT THERAPEUTIC STEP

  • A. Add leukotriene antagonist
  • B. Add long acting inhaled beta 2 agonist ✓
  • C. Add oral theophylline
  • D. Double the dose of inhaled corticosteroid
  • E. Replace inhaled steroid with oral corticosteroid

 

In this scenario, the most appropriate next therapeutic step for the 18-year-old man with asthma who has gradually increasing breathlessness and wheeze despite regular use of his salbutamol and corticosteroid inhalers would be to add a long-acting inhaled beta 2 agonist (option B). Long-acting beta-agonists are recommended as an add-on therapy for patients whose asthma is not well controlled on low-to-medium doses of inhaled corticosteroids. They provide bronchodilation and can improve symptoms and lung function in patients with persistent asthma.

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