A 68-year-old male with a 20-year history of severe chronic…
A 68-year-old male with a 20-year history of severe chronic obstructive pulmonary disease (COPD) is managed at home with a medication regimen that includes tiotropium bromide (Spiriva) and albuterol. Despite adherence to this regimen, he continues to report frequent dyspnea on exertion. Last Spirometry Results: Parameter Result (Percent of Predicted) FVC 72% FEV₁ 42% FEV₁/FVC 58% Which of the following medications should the respiratory therapist recommend adding to the treatment plan to improve symptom control?