S.C. is a 21-year-old college student. She presents with intermittent wheezing. She has a history of asthma as a child but had been free of symptoms until this year. She has symptoms 1 to 2 days per week but denies nocturnal wheezing. Her symptoms do not interfere with her normal activities. She has never taken systemic corticosteroids and has never been hospitalized for asthma. On physical exam, you observe soft end-expiratory wheezing at the bases bilaterally. Pulmonary function tests today show an FEV1/FVC of 80% with an FEV1 90% of predicted. She has no other medical conditions and and is not taking any nonprescription, prescription or complementary alternative medicines. She has no known environmental or drug allergies.
DX: Asthma
1. List specific goals for treatment for S.C.
2. What drug therapy would you prescribe? Why?
3. Write prescription for drug therapy prescribed.
4. What are the parameters for monitoring success of the therapy?
5. List one or two adverse reactions for the selected agent that would cause you to change therapy.
6. What would be the choice for second-line therapy?
7. What over the counter and/or alternative medications would be appropriate for S.C.?
8. What lifestyle changes would you recommend for S.C.?
9. Describe one or two drug-drug or drug-food interactions for the selected agent.
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