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CHOROBY WEWNĘTRZNE (28/1807)

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Chory, u którego rozpoznano astmę oskrzelową, otrzymał wziewny budesonid w dawce 2 razy 200 μg i salbutamol jako lek ratunkowy. Po 4 tygodniach zgłosił się na kolejną wizytę. Obecnie zgłasza poprawę samopoczucia, wybudzenia nocne z powodu kaszlu co najmniej 1 x w tygodniu, utrzymuje się gorsza tolerancja wysiłku, zużycie salbutamolu 1-2 razy dziennie. Właściwym postępowaniem jest:
A - pozostawienie dotychczasowych leków w takich samych dawkach, ponieważ uzyskano poprawę.
B - zalecenie przyjmowania salbutamolu w stałych dawkach np. 2 wdechy co 6 godzin.
C - dołączenie teofiliny.
D - dołączenie kromonów.
E - dołączenie długodziałającego beta-mimetyku lub zastąpienie wziewnego steroidu lekiem złożonym, zawierającym obydwa leki. Należy rozważyć zwiększenie dawki wziewnego steroidu.
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