Question

A 72-year-old man with severe COPD (FEV₁ 38% predicted), frequent exacerbations and persistent dyspnoea despite a long-acting muscarinic antagonist (LAMA) presents to clinic. He continues to smoke 10 cigarettes per day. According to the 2023 CTS COPD pharmacotherapy guideline, what is the most appropriate next escalation of inhaled therapy?

Accepted Answer

Add a long-acting beta-agonist (LABA) to create dual bronchodilator therapy with LAMA/LABA.

Answer

Switch from LAMA to short-acting beta-agonist monotherapy.

Answer

Add an inhaled corticosteroid to form triple therapy with LAMA/LABA/ICS.

Answer

Continue LAMA alone and add prophylactic oral antibiotics.

Answer

Start chronic oral prednisone 10 mg daily.

Practice question