Question

Rick is a 44 y.o. old male who comes to the clinic with a complaint of allergies and asthma. He has had mild intermittent asthma for years that is triggered by allergies and respiratory infections. The past few weeks his seasonal allergies have been bothering him, and he has been using his albuterol a couple times a day for a wheezy cough. He has been taking Benadryl for his allergies, but doesn’t like it because it makes him sleepy and he cannot take it and work. He is able to work, but he said he cannot finish his routine 5-mile run each day due to coughing. He is afebrile, his oxygen saturation is 95% on room air, his in-office spirometry indicates his FEV₁ is 75% of predicted. His only medications are the albuterol inhaler and Benadryl.

1. What would be the appropriate prescription for him today?

Answer 1

The patient is a known case of asthmatic.The only symptoms exhibited by the patient is cough which is wheezy, the other parameters are within normal limits.This leads to the suspecting of cough variant asthma or asthma cough ,where cough can occur due to exercise or any allergens.The appropriate prescription for him are

• To continue the bronchodilator (albuterol)
• A steroid inhaler can be prescribed to reduce any small airway inflammation and prevent wheezing
• Oral:Montelukast is one of the preferred choice of drug to prevent cough in asthma in these types of patients