Respiratory Case Study TL is a 65

Respiratory Case Study TL is a 65 year old male previously diagnosed with asthma. He is now complaining of increased shortness of breath when he goes for his walk after work, and needs to use his albuterol daily. He reports that he was seen in the ER 3 months ago for asthma and was treated with oral steroids (prednisone) for 5 days which helped and relieved his symptoms. Since then he has continued to use his albuterol daily and is now reporting that he waking at least once a week with asthma symptoms. What medication(s) can be added to TL’s asthma regime to prevent his asthma exacerbations? How would TL benefit from using a long acting inhaled beta 2 agonist to treat his asthma? What is the pharmacologic difference between inhaled corticosteroids vs. oral corticosteroids, and what patient teaching is necessary when prescribing an inhaled corticosteroid? You see TL for a follow up appointment in 8 months and his respiratory status is moving toward COPD, Chronic Obstructive Lung Disease which is enhanced by chronic inflammatory response in the airways. At this point you feel that you need to add an anticholinergic medication to his regimen. What is the mechanism of action of an inhaled anticholinergic medication such as ipratropium?

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