- A. Add leukotriene antagonist
- B. Add long acting inhaled beta 2 agonist ✓
- C. Add oral theophylline
- D. Double the dose of inhaled corticosteroid
- E. Replace inhaled steroid with oral corticosteroid
In this scenario, the most appropriate next therapeutic step for the 18-year-old man with asthma who has gradually increasing breathlessness and wheeze despite regular use of his salbutamol and corticosteroid inhalers would be to add a long-acting inhaled beta 2 agonist (option B). Long-acting beta-agonists are recommended as an add-on therapy for patients whose asthma is not well controlled on low-to-medium doses of inhaled corticosteroids. They provide bronchodilation and can improve symptoms and lung function in patients with persistent asthma.
