A primary care NP is evaluating a patient who has COPD. The patient uses a LABA twice daily. The patient reports having increased exertional dyspnea, a frequent cough, and poor sleep
The patient also uses a short-acting ?-adrenergic agonist (SABA) five or six times each day. Pulse oximetry reveals an oxygen saturation of 92%. The patient's FEV1/forced vital capacity is 65, and FEV1 is 55% of predicted. The NP should prescribe a(n): a. oral corticosteroid.
b. long-acting anticholinergic.
c. long-acting oral theophylline.
d. combination ICS/LABA inhaler.
D
Providers should administer combination inhaled therapies for symptomatic patients with stable COPD and FEV1 less than 60%. Oral corticosteroids have not been shown to be effective, even in severe cases of COPD. Long-acting anticholinergic medications may be used as monotherapy in early stages of COPD. Long-acting theophylline is poorly tolerated because of side effects.
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