[Answered]: MP is a 62 y/o male with chronic bronchitis who…

MP is a 62 y/o male with chronic bronchitis who presents in clinic complaining of recent worsening dyspnea and productive cough. Last month he started using a Proventil inhaler which he claims usually helps him tolerate climbing stairs. He asks you if the medication has “worn off.” MP reports compliance with using the albuterol inhaler and demonstrates “correct MDI technique.” PMH: chronic bronchitis, HTN. Allergies: NKDA Vitals: T=100.4 P=70 R=18 B/P=136/84 SaO2=94% PE: Cough w/ copious amounts of white sputum (he doesn’t cough any up in clinic today, so you are unable to see the color) Breath sounds distant on auscultation with rhonchi and wheezing CXR – no infiltrates noted in lung fields, cardiac silhouette elongated, flattening of diaphragms. SH: Smokes 2 ppd × 45 years Drinks 2-3 beers each evening Current medications: Albuterol MDI 2 puffs every 4-6 hrs (w/spacer) Guaifenesin 600mg tablets 1 BID Lisinopril 10 mg daily Please post your answer using the case evaluation template as a guide and include at least 1 written prescription. Reply