A patient with asthma requiring a preventer inhaler is prescribed propranolol for migraine prevention. She has previously wheezed after a non-selective beta-blocker. What is the best prescribing response? A Start propranolol as written and increase the inhaled corticosteroid dose for the first month to suppress any bronchospasm B Replace propranolol with timolol tablets because shorter-acting non-selective beta-blockade is safer in asthma C Use propranolol only on headache days because intermittent exposure removes the pulmonary contraindication and provides acute relief D Withhold propranolol and request a non-beta-blocker preventive choice that accounts for comorbidity and potential pregnancy E Start propranolol at half dose with salbutamol cover because gradual titration prevents beta-2-mediated bronchoconstriction
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