A 72-year-old woman comes to the office because of increasing cough


#1

A 72-year-old woman comes to the office because of increasing cough and shortness of breath for the past 3 days. She has had a left-sided frontal headache and some sweats, but she has not had fever. She has a history of allergic rhinitis, asthma, hypertension, and irritable bowel syndrome. Her medications include hydrochlorothiazide, albuterol by inhaler, and dietary fiber. Today, vital signs are temperature 37.2°C (99.0°F), pulse 88/min, respirations 20/min, and blood pressure 135/85 mm Hg. Physical examination discloses nasal congestion, mild tenderness over the left maxilla, and diffuse expiratory wheezes throughout the lungs. The remainder of the physical examination shows no abnormalities. Peak expiratory flow rate is 260 L/min; her baseline rate is approximately 400 L/min. In addition to amoxicillin, which of the following is the most appropriate pharmacotherapy?

A) Guaifenesin and ipratropium
B) Guaifenesin and loratadine
C) Guaifenesin and prednisone
D) Pseudoephedrine and loratadine
E) Pseudoephedrine and theophylline

Acute exacerbation of asthma
O2+ antibiotic+ steroid+ brochodilator