Question

A 68-year-old former smoker with GOLD stage 3 chronic obstructive pulmonary disease (FEV1 35 percent predicted) has had three moderate exacerbations requiring oral steroids and antibiotics in the past year despite taking tiotropium. According to Canadian COPD guidelines, which escalation is most appropriate?

Accepted Answer

Escalate to a combination long-acting beta₂-agonist and long-acting muscarinic antagonist inhaler

Answer

Add a short-acting beta₂-agonist only

Answer

Switch tiotropium to an inhaled corticosteroid alone

Answer

Start chronic oral prednisone 10 mg daily

Answer

Stop tiotropium and use short-acting bronchodilators as needed only

Practice question