Question

A 58-year-old man with COPD presents with increased breathlessness, purulent sputum and wheeze. His usual inhalers include a long-acting muscarinic antagonist and a long-acting beta-agonist. On examination, respiratory rate is 26/min, saturations 90% on air, with widespread wheeze. What is the most appropriate initial pharmacological treatment for this acute exacerbation in primary care?

Accepted Answer

Start a short course of oral prednisolone and an appropriate oral antibiotic, and increase short-acting bronchodilator use

Answer

Increase his long-acting inhalers and review in 1 week

Answer

Start long-term oxygen therapy at home immediately

Answer

Give intravenous diuretics to reduce pulmonary congestion

Answer

Stop all inhalers and start oral theophylline

Practice question