Question

martin is a 73 y/o male who has a 50 year/pack history of smoking and comes to the clinic for his annual physical. as you are leading him back to the exam room you note that he has dyspnea with minimal cough, a barrel chest, and appears to have lost weight since his last visit. your physical exam confirms a 20 lb. weight loss, and a more noticeable pursed lip breathing. given martins condition the first line treatment would be all the following except:
○ albuterol
○ salmeterol
○ levalbuterol
○ metaproterenol

Explanation:

Martin has symptoms like dyspnea, barrel - chest, weight loss and pursed - lip breathing with a long - term smoking history, suggesting chronic obstructive pulmonary disease (COPD). Albuterol, Salmeterol, and Levalbuterol are common bronchodilators used as first - line treatments for COPD. Metaproterenol is less commonly used as a first - line treatment for COPD compared to the others.

Answer:

D. metaproterenol