After administering 12 puffs of metered dose inhaler (MDI) albuterol to an acutely ill asthmatic patient in the emergency department, assessment indicates no significant improvement in symp-toms. Which of the following would you now recommend?
a. Switch over to high-dose MDI steroids.
b. Discontinue the bronchodilator therapy.
c. Use continuous bronchodilator therapy.
d. Switch over to an anticholinergic agent.
ANS: C
If these strategies fail to provide relief, continuous bronchodilator therapy (CBT) with nebulized albuterol doses ranging from 5 to 20 mg/hr have proved safe and effective for both adult and pe-diatric patients.
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