Joe is 13 years old and was diagnosed with mild, intermittent asthma 1 year ago. At his quarterly follow up visit, you discover he is using his Albuterol MDI at least 5 times a week (with good technique) for relief of symptoms. His mother reports that he also awakens at night frequently due to coughing and wheezing. On exam, you hear occasional end expiratory wheezing throughout that clear to albuterol nebulizer treatment. These findings best indicate that: O A nebulizer should be used rather than an MDI (metered dose inhaler) to deliver the Albuterol. • A Combivent (Atrovent and Albuterol) MDI should be added to the regimen. O Daily use of an anti-inflammatory medication such as a low to medium dose steroid inhaler should be added to the regimen. • Daily oral prednisone should be added to the regimen.
