Question

A 68-year-old with severe COPD is on LAMA/LABA/ICS and continues to exacerbate. He quit smoking last year. Eosinophils 80/µL. Next step?

Accepted Answer

Consider roflumilast if chronic bronchitis and FEV₁ <50% or macrolide if former smoker; optimize nonpharmacologic care

Answer

Increase ICS indefinitely regardless of eosinophils

Answer

Chronic oral steroids

Answer

Stop bronchodilators

Answer

No vaccinations needed

Practice question

A 68-year-old with severe COPD is on LAMA/LABA/ICS and continues to exacerbate. He quit smoking last year. Eosinophils 80/µL. Next step?