PEBC MCQ Asthma, COPD & Smoking Cessation question: week for symptoms during exercise and colds

PEBC MCQAsthma, COPD & Smoking Cessation

GN, 28, has asthma and uses salbutamol 2 to 3 times a week for symptoms during exercise and colds. She has no night waking and has never needed oral corticosteroids. She uses no controller. According to the CTS 2021 asthma update, what is the most appropriate change?

a. As-needed budesonide-formoterol in place of salbutamol
b. Add montelukast 10 mg daily and keep salbutamol as needed
c. Add salmeterol twice daily and keep salbutamol as needed
d. Continue salbutamol as needed, since her asthma is mild

Show the answer and explanation

Answer: a. As-needed budesonide-formoterol in place of salbutamol

The 2021 CTS focused update no longer recommends SABA-only treatment for adults and adolescents with asthma, because it is linked to more severe exacerbations and deaths. Mild asthma is treated with as-needed budesonide-formoterol or with a daily low-dose ICS plus an as-needed reliever. A LABA without an ICS is unsafe in asthma, and montelukast is less effective than ICS as a controller. Source: Yang CL et al. Canadian Thoracic Society 2021 Guideline update: diagnosis and management of asthma in preschoolers, children and adults (Can J Respir Crit Care Sleep Med 2021;5:348); budesonide/formoterol (Symbicort) product monograph (DPD, checked 2026).

Common mistake

Leaving mild asthma on SABA alone, or using a LABA without an ICS.

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