A 71-year-old male presents for a follow-up appointment afte…

Questions

A 71-yeаr-оld mаle presents fоr а fоllow-up appointment after a recent ED visit for COPD exacerbation. He doesn’t believe his medications are “working as well as they used to.” He has had 2 exacerbations in the past year, during his most recent hospitalization he was also diagnosed with pneumonia, and he wants to avoid more hospitalizations. His current respiratory medications include albuterol HFA MDI 2 puffs q4h prn SOB and olodaterol 2.5mcg/inh 2 inhalations daily.  Diagnostic testing: FEV1 45% predicted, FEV1/FVC ratio: 42%  Symptoms: mMRC: 1  Eosinophil count: 57  What do you recommend for maintenance therapy? 

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