A 65-year-old ex-smoker with COPD reports daily breathlessness on exertion despite using a short-acting bronchodilator inhaler as required. Spirometry...

Question

A 65-year-old ex-smoker with COPD reports daily breathlessness on exertion despite using a short-acting bronchodilator inhaler as required. Spirometry shows FEV1 45% predicted. He has one moderate exacerbation per year. What is the most appropriate next step in inhaled maintenance therapy?

Accepted Answer

Add a long-acting muscarinic antagonist (LAMA)

Answer

Add inhaled corticosteroid monotherapy

Answer

Add a long-acting beta2-agonist (LABA) only

Answer

Switch to inhaled corticosteroid/long-acting beta2-agonist combination

Answer

Start regular oral prednisolone

uk-plab-1 MCQ (SBA): Chronic obstructive pulmonary disease

A 65-year-old ex-smoker with COPD reports daily breathlessness on exertion despite using a short-acting bronchodilator inhaler as required. Spirometry shows FEV1 45% predicted. He has one moderate exacerbation per year. What is the most appropriate next step in inhaled maintenance therapy?