A primary care nurse practitioner (NP)is evaluating a patient with asthma who reports having wheezing and coughing 1 or 2 days each week and awakening from sleep three or four times each month with asthma symptoms.The patient's forced expiratory volume in 1 second (FEV₁)is 80% of the predicted value.The patient's current medication regimen is an albuterol metered-dose inhaler,2 puffs every 4 hours as needed.The NP should prescribe:

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This patient has symptoms of mild,persistent asthma.The preferred controller medication in adults and children with persistent asthma is a low-dose ICS.Montelukast is a leukotriene modifier,which may be considered as an alternative to a low-dose ICS but is not the first option to try.Ipratropium is often used during an acute exacerbation but not for long-term control.LABA medications are used in patients with moderate persistent symptoms.

A Primary Care Nurse Practitioner (NP)is Evaluating a Patient with Asthma