Reference no: EM133664212

Assignment:

Zack, age 6, presents to the office with symptoms of worsening cough and wheezing for the past 24 hours. He is accompanied by his mother, who is a good historian. She reports that her son started having symptoms of a viral upper respiratory infection 2 to 3 days ago, beginning with a runny nose, low-grade fever of 100.5ºF orally, and loose cough. Wheezing started on the day before the visit, so Zack's mother administered albuterol metered-dose inhaler (MDI) two puffs before bed and then two puffs at around 2 a.m. The cough and wheezing appear worse today, according to the mother. Zack had difficulty taking deep-enough breaths to inhale this morning's dose of albuterol, even using the spacer. Zack has been a patient at the clinic since birth and is up to date on his immunizations. His growth and development have been normal, and he has been generally healthy except for mild intermittent asthma. His asthma is usually precipitated by a viral upper respiratory infection. He has required oral prednisone an average of two or three times per year for the past 3 years. He has an albuterol MDI at home with a spacer, which his parents are comfortable using.

• Which medications do you feel are safe and appropriate to utilize initially?
• Which medications do you feel will be safe and appropriate to prescribe and/or recommend for chronic, ongoing management?