Question:
A patient already on salbutamol and ipratropium continues to have nocturnal exacerbations of asthma. What is the next step?
A patient already on salbutamol and ipratropium continues to have nocturnal exacerbations of asthma. What is the next step?
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Asthma with persistent or nocturnal symptoms needs controller therapy, commonly inhaled corticosteroid with LABA.
Updated On: May 14, 2026
- Oral corticosteroids
- Montelukast
- LABA plus inhalation steroids
- Increase the dose of salbutamol
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The Correct Option is C
Solution and Explanation
Concept:
Persistent asthma symptoms, especially nocturnal symptoms, require controller therapy. Inhaled corticosteroids are the foundation, and LABA is added when symptoms are not controlled.
Step 1: Identify poor control.
Nocturnal exacerbations indicate asthma is not adequately controlled.
Step 2: Recognize current therapy.
Salbutamol and ipratropium are bronchodilators, but they do not provide adequate long-term anti-inflammatory control.
Step 3: Choose next step.
The next step is: \[ \text{LABA plus inhaled corticosteroids} \]
Step 1: Identify poor control.
Nocturnal exacerbations indicate asthma is not adequately controlled.
Step 2: Recognize current therapy.
Salbutamol and ipratropium are bronchodilators, but they do not provide adequate long-term anti-inflammatory control.
Step 3: Choose next step.
The next step is: \[ \text{LABA plus inhaled corticosteroids} \]
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